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Two cases in which tofacitinib effectively treated both ulcerative colitis and alopecia areata

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Abstract

A 40-year-old woman (case 1) visited the hospital complaining of diarrhea and was diagnosed with ulcerative colitis (UC). She was administered 5-aminosalicylic acid (5-ASA), but developed intolerance. Prednisolone (PSL) was administered, and her symptoms improved. However, alopecia areata developed as the PSL was tapered, and her UC relapsed. Adalimumab, Infliximab (IFX), and golimumab were used, but all showed insufficient efficacy. Therefore, we started tofacitinib (TOF). Her bloody stools and diarrhea improved 3 days after TOF administration, and clinical remission occurred on day 14. Her alopecia areata improved 14 days after starting TOF and improved completely during TOF maintenance therapy. A 19-year-old man (case 2) had developed alopecia areata at 10 years old and was diagnosed with UC at 17 years old. He achieved sustained remission with IFX, but then stopped IFX to receive a live vaccination. His UC relapsed 4 months later, immediately after the live vaccine was administered. Vedolizumab was administered, but was ineffective, as was re-administration of IFX. TOF was administered, and his clinical symptoms improved 7 days later. He achieved clinical remission on day 20. In addition, his hair began to regrow 14 days after starting TOF.

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Abbreviations

5-ASA:

5-Aminosalicylic acid

JAK:

Janus kinase

IFX:

Infliximab

PSL:

Prednisolone

STAT:

Signal transducers and activation of transcription

TOF:

Tofacitinib

UC:

Ulcerative colitis

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Acknowledgements

We thank Traci Raley, MS, ELS, from Edanz Group (https://www.edanzediting.com/ac) for editing a draft of this manuscript.

Funding

This work was supported in part by grants from the Japan Sciences Research Grant for Research on Intractable Diseases (Japanese Inflammatory Bowel Disease Research Group) affiliated with the Japan Ministry of Health, Labour and Welfare.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan

    Oki Kikuchi, Daisuke Saito, Miki Miura, Haruka Wada, Ryo Ozaki, Sotaro Tokunaga, Shintaro Minowa, Tatsuya Mitsui, Akihito Sakuraba, Mari Hayashida, Jun Miyoshi, Minoru Matsuura & Tadakazu Hisamatsu

  2. Department of Dermatology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan

    Masahiro Fukuyama & Manabu Ohyama

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  1. Oki Kikuchi
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Corresponding author

Correspondence to Daisuke Saito.

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Conflict of interest

Tadakazu Hisamatsu received honoraria from EA pharma Co. Ltd., AbbVie GK, Celgene K.K., Janssen Pharmaceutical K.K., Pfizer Inc., Takeda Pharmaceutical Co. Ltd., Mitsubishi Tanabe Pharma Corporation, Kyorin Pharmaceutical Co. Ltd., JIMRO Co. Ltd., Mochida Pharmaceutical Co., Ltd., Nichi-lko Pharmaceutical Co., Ltd, and commercial research funding from EA pharma Co. Ltd., AbbVie GK, Daiichi-Sankyo Co. Ltd., Takeda Pharmaceutical Co. Ltd., Pfizer Inc., Mochida Pharmaceutical Co., Ltd, Nippon Kayaku Co. Ltd., Kyorin Pharmaceutical Co. Ltd., JIMRO Co. Mochida Pharmaceutical Co., Ltd., Astellas Pharma Inc., ZERIA Pharmaceutical Co. Ltd. Manabu Ohyama received lecture fees from Eli Lilly and company and Pfizer Inc.. Minoru Matsuura received honoraria from AbbVie GK, Mitsubishi Tanabe Pharma Corporation, EA pharma Co. Ltd., Kyorin Pharmaceutical Co. Ltd., Mochida Pharmaceutical Co., Ltd., Janssen Pharmaceutical K.K., Nioppon Kayaku Co. Ltd., Kissei Pharmaceutical Co. Ltd., and commercial research funding: from AbbVie GK, Mitsubishi Tanabe Pharma Corporation, EA pharma Co. Ltd., Mochida Pharmaceutical Co., Ltd., Nioppon Kayaku Co. Ltd., JIMRO Co. Oki Kikuchi, Daisuke Saito, Miki Miura, Haruka Wada, Ryo Ozaki, Sotaro Tokunaga, Shintaro Minowa, Masahiro Fukuyama, Tatsuya Mitsui, Akihito Sakuraba, Mari Hayashida, Jun Miyoshi, declare that they have no conflict of interest.

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All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Informed consent was obtained from all patients for being included in the study.

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Kikuchi, O., Saito, D., Miura, M. et al. Two cases in which tofacitinib effectively treated both ulcerative colitis and alopecia areata. Clin J Gastroenterol 13, 788–793 (2020). https://doi.org/10.1007/s12328-020-01150-3

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  • DOI: https://doi.org/10.1007/s12328-020-01150-3

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