Usage of Tofacitinib as a Steroid-sparing Therapy in Pulmonary and Cutaneous Sarcoidosis

Background: Sarcoidosis is a multisystem, granulomatous & chronic illness which typically affecting lymph nodes & lungs also any organ system. We aimed to evaluate the tofacitinib effectiveness as cutaneous & pulmonary sarcoidosis steroid-sparing treatment.

Methods: This retrospective cohort observational research was performed on 45 cases aged from 20 to 65 years old, both sexes, a forced vital capacity (FVC) >50%, histology consistent with sarcoidosis, pulmonary sarcoidosis definition by association for Sarcoidosis and other Granulomatous Disorders (WASOG) & disease progression or symptoms necessitating 15-30 mg/day prednisone (or comparable corticosteroids) as a consistent dose of for at least 4 weeks before enrolment. The definition of Steroid-dependent disease was the necessity for steroids for disease symptoms or progression control, but pulmonary impairment on pulmonary function testing was not required. Additionally, all instances with a history of failed attempts to reduce corticosteroid doses, and their treating physicians urged steroid-sparing therapy.

Results: Pulmonary function tests (FVC, FEV1, FEV1/ FVC ratio) were significantly improved after treatment compared to baseline (P value <0.001). 41 (91.1%) patients showed pulmonary improvement. The last evaluated CSAMI activity score was significantly lower compared to baseline CSAMI activity score (6.38 ± 2.7 vs. 39.51 ± 14.1, P <0.001). The mean CSAMI activity score decrease was 33.13± 11.4%.

Conclusions: Tofacitinib is a promising strategy for of cutaneous & pulmonary sarcoidosis treatment.