A Retrospective Analysis of Cases of Chronic Spontaneous Urticaria on Treatment with Oral Tofacitinib

The term chronic spontaneous urticaria (CSU) can be defined as urticaria lasting for more than 6 weeks with no established aetiology. Many newer molecules are being tried for managing the CSU cases not responding to conventional treatment as higher doses of antihistamines, oral steroids, oral methotrexate, oral cyclosporine, omalizumab, etc. One such oral agent is tofacitinib. Tofacitinib is known to inhibit the JAK -STAT pathway hence the release of many inflammatory cytokines and so target the pathophysiology of CSU and control symptoms of urticaria. Through this study, we have tried to bring out the efficacy and safety profile of this agent in resolving urticarial symptoms.

All cases of CSU who had not responded to higher recommended doses of anti-histamine (as per EACI guidelines) and on one or the other immunosuppressive agents were included in the study and based on baseline investigations and patients’ response to initial doses of tofacitinib and patient’s consent six patients were withdrawn from the study.

Out of 15 patients of CSU included for final evaluation, 10 patients were completely cured of CSU at 6 months and 3 patients responded partially.

Tofacitinib is an innovative molecule for treating antihistamine non-responding cases of chronic spontaneous urticaria.