Efficacy of adjunctive oral Janus kinase inhibitors in hospitalized patients with extensive or difficult-to-control drug eruptions: a retrospective observational case series
- 1epartment of Dermatology, Shenzhen Nanshan People’s Hospital/Affiliated Nanshan Hospital of Shenzhen University, Shenzhen, Guangdong, China
Abstract
BackgroundEvidence for Janus kinase (JAK) inhibition in severe or difficult-to-control drug eruptions remains limited, particularly regarding early response kinetics and corticosteroid reduction.MethodsThis single-center retrospective observational case series included nine hospitalized patients with extensive or difficult-to-control drug eruptions treated with adjunctive oral JAK inhibitors between March 2023 and January 2026. Cases 1–7 formed a rescue treatment subgroup because active progression persisted after at least 48 h of systemic corticosteroids. The primary outcome was the first documented absence of new lesions within 72 h. Secondary outcomes included serial changes in Worst Itch Numerical Rating Scale (WI-NRS) and body surface area (BSA), time to corticosteroid reduction, recurrence, and safety. Within-patient changes were assessed using Friedman tests, with exact Wilcoxon signed-rank tests and Holm correction for post hoc comparisons.ResultsThe rescue subgroup received systemic corticosteroids for a median of 72 h before JAK inhibitor initiation (IQR, 48–96 h). New lesions were first documented as absent within 24 h in 6/7 patients and within 48 h in all seven. All seven began corticosteroid reduction within 96 h (median, 48 h). Across all nine patients, median WI-NRS decreased from 6 at baseline to 1 at 72 h [Friedman χ2(4) = 35.04, P < 0.001; Kendall's W = 0.973], and all patients achieved a reduction of at least 3 points. Median BSA decreased from 55% at baseline to 30% at day 3 and 10% by day 7 or discharge [Friedman χ2(2) = 18.00, P < 0.001; Kendall's W = 1.000]. Two herpes simplex-related events occurred during combined immunosuppression.ConclusionAdjunctive oral JAK inhibitors were associated with rapid control of new-lesion formation, substantial improvement in pruritus and cutaneous involvement, and early corticosteroid reduction. These findings support JAK inhibition as a promising rescue or steroid-sparing option for selected difficult-to-control drug eruptions and warrant prospective controlled evaluation.
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BibTeX
@article{zhu2026efficacy,
title = {{Efficacy of adjunctive oral Janus kinase inhibitors in hospitalized patients with extensive or difficult-to-control drug eruptions: a retrospective observational case series}},
author = {Yunkai Zhu and Xia Wang and Yuhang Huang and Ming Wang and Lixian Lin and Jinsheng Li and Peiyi Feng and Yuan Lu and Xiaoming Liu and Bao Chai and Peng Wang},
journal = {Frontiers in Medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1947886},
url = {https://doi.org/10.3389/fmed.2026.1947886},
note = {CC BY},
}
RIS
TY - JOUR
TI - Efficacy of adjunctive oral Janus kinase inhibitors in hospitalized patients with extensive or difficult-to-control drug eruptions: a retrospective observational case series
AU - Yunkai Zhu
AU - Xia Wang
AU - Yuhang Huang
AU - Ming Wang
AU - Lixian Lin
AU - Jinsheng Li
AU - Peiyi Feng
AU - Yuan Lu
AU - Xiaoming Liu
AU - Bao Chai
AU - Peng Wang
PY - 2026
DA - 2026/10/26
JO - Frontiers in Medicine
DO - 10.3389/fmed.2026.1947886
UR - https://doi.org/10.3389/fmed.2026.1947886
AB - BackgroundEvidence for Janus kinase (JAK) inhibition in severe or difficult-to-control drug eruptions remains limited, particularly regarding early response kinetics and corticosteroid reduction.MethodsThis single-center retrospective observational case series included nine hospitalized patients with extensive or difficult-to-control drug eruptions treated with adjunctive oral JAK inhibitors between March 2023 and January 2026. Cases 1–7 formed a rescue treatment subgroup because active progression persisted after at least 48 h of systemic corticosteroids. The primary outcome was the first documented absence of new lesions within 72 h. Secondary outcomes included serial changes in Worst Itch Numerical Rating Scale (WI-NRS) and body surface area (BSA), time to corticosteroid reduction, recurrence, and safety. Within-patient changes were assessed using Friedman tests, with exact Wilcoxon signed-rank tests and Holm correction for post hoc comparisons.ResultsThe rescue subgroup received systemic corticosteroids for a median of 72 h before JAK inhibitor initiation (IQR, 48–96 h). New lesions were first documented as absent within 24 h in 6/7 patients and within 48 h in all seven. All seven began corticosteroid reduction within 96 h (median, 48 h). Across all nine patients, median WI-NRS decreased from 6 at baseline to 1 at 72 h [Friedman χ2(4) = 35.04, P < 0.001; Kendall's W = 0.973], and all patients achieved a reduction of at least 3 points. Median BSA decreased from 55% at baseline to 30% at day 3 and 10% by day 7 or discharge [Friedman χ2(2) = 18.00, P < 0.001; Kendall's W = 1.000]. Two herpes simplex-related events occurred during combined immunosuppression.ConclusionAdjunctive oral JAK inhibitors were associated with rapid control of new-lesion formation, substantial improvement in pruritus and cutaneous involvement, and early corticosteroid reduction. These findings support JAK inhibition as a promising rescue or steroid-sparing option for selected difficult-to-control drug eruptions and warrant prospective controlled evaluation.
SN - 2296-858X
ER -