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Assessment of clinical response to Janus kinase inhibition in patients with familial chilblain lupus and TREX1 mutation

JAMA Jan 26, 2019

Zimmermann N, et al. - In this case series, researchers assessed the clinical response to the Janus kinase inhibitor baricitinib in familial chilblain lupus, a monogenic autosomal dominant form of cutaneous lupus erythematosus that, in most cases, is caused by mutations in the 3 prime repair exonuclease 1 (TREX1), and evaluated the effect of cold on patient fibroblasts. For this investigation, three patients with familial chilblain lupus due to TREX1 mutation had treatment with baricitinib for 3 months. The outcomes exhibited the therapeutic effectiveness of Janus kinase inhibition in a monogenic lupus form in three patients and provided mechanistic insight into the cold exacerbation process in TREX1-deficient cells. For multifactorial cutaneous lupus erythematosus, this finding might be relevant to other type I interferon (IFN)–mediated disorders and suggests Janus kinase inhibition as a potential therapeutic option also. There were no serious adverse reactions reported.

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