Researchers behind a new study that showed how an arthritis drug led to a dramatic improvement in eczema patients say it could transform the standard care for the skin condition, for which there is no targeted therapy.
Eczema commonly starts during infancy and persists through into childhood. Some people outgrow it, while others continue to have it into adulthood. Standard treatments, such as steroid creams and oral medicines, often fail to relieve symptoms in patients with moderate to severe eczema.
In the Journal of the American Academy of Dermatology, the researchers – from Yale School of Medicine in New Haven, CT – describe how they successfully used a rheumatoid arthritis drug to treat six patients with moderate to severe eczema.
During treatment, all six patients – whose eczema had not responded to conventional treatments – reported significant reduction in itch. Their skin also reduced in redness and thickening, and they also reported improved sleep.
Senior author Brett King, assistant professor of dermatology, says:
“These individuals were not only very happy with the results, they also expressed a tremendous sense of relief at being comfortable in their skin for the first time in many years.”
Recent years have seen a shift in the debate about the causes of eczema – with more evidence suggesting it may be an autoimmune disease. If that is the case, then Prof. King and colleagues wondered if tofacitinib citrate – a drug approved for the treatment of rheumatoid arthritis – would interrupt the immune response that causes eczema.
Prof. King was involved in two earlier studies of the same drug. One showed that tofacitinib citrate could be used to treat the disfiguring skin condition vitiligo, and the other study showed how the drug helped a man with alopecia areata grow a full head of hair.
Alopecia areata is an autoimmune disorder where the immune system attacks the hair follicles. Vitiligo is also thought to be an autoimmune disorder where the immune system targets skin cells called melanocytes.
Tofacitinib citrate blocks enzymes called Janus kinases (JAKs) that are involved in inflammation in rheumatoid arthritis – a chronic autoimmune disorder that affects the lining of the joints.
If unblocked, JAKs can signal the release inflammatory cytokines that attack the joints and other tissues. The goal of rheumatoid arthritis treatment with tofacitinib is to reduce inflammation and disease activity.
Prof. King says their findings could transform the way that eczema is treated, and concludes:
“Eczema affects millions of children and adults in the United States. I’m hopeful we are entering a whole new era in treatment.”
However, he and his colleagues also point out that further research is now needed to confirm that the treatment is safe and to examine its longer-term effectiveness.