Effectiveness and Safety of Tofacitinib as Adjunctive therapy for DRESS: A Real-World Study
In brief
Tofacitinib shortens steroid treatment by about 30 days in DRESS
In a retrospective series of 61 patients, adding tofacitinib to standard glucocorticoids accelerated rash clearance (median 10 vs 13.5 days) and reduced steroid exposure-from 88 to 58 days and cumulative dose by roughly 700 mg. The drug appeared safe, but mortality differences were not statistically significant, and randomized trials are still needed.
- Journal
- Journal of the American Academy of Dermatology (Q1)
- Published
- 7 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Xiaoyu Wang, Yingying Yan, Yinchu Cheng, Jiachen Sun, Jinzhu Guo, Yinuo Yang, et al.
- PMID
- 42705350
- DOI
- 10.1016/j.jaad.2026.09.010
Why clinicians should know about it
- Picked for Dermatology (top studies of the week, 13 September 2026): Adjunctive tofacitinib reduces glucocorticoid exposure in DRESS
Abstract
BACKGROUND: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe multisystem hypersensitivity reaction. While systemic glucocorticoids remain the cornerstone treatment, patients often exhibit resistance, intolerance, or relapse during tapering, highlighting an urgent need for effective strategies. OBJECTIVE: To assess the effectiveness and safety of tofacitinib as an adjunctive therapy in patients with DRESS. METHODS: We retrospectively analyzed patients with DRESS treated from January 2018 to June 2025, comparing systemic glucocorticoids alone versus glucocorticoids plus tofacitinib. Primary outcome was cumulative glucocorticoid exposure; secondary outcomes included clinical improvement and safety. We used multivariable regression and sensitivity analyses to adjust for potential confounding factors. RESULTS: Among 61 patients (37 [60.7%] female; 25 [41.0%] severe DRESS), adjunctive tofacitinib was associated with shorter time to near-complete rash resolution (median, 10.0 vs 13.5 days; p = 0.032), reduced glucocorticoid duration (58.0 vs 88.0 days; p < .001), and lower cumulative dose (1452.0 vs 2145.0 mg; p = 0.019). In adjusted analyses, tofacitinib remained associated with 24.9% reduction in glucocorticoid duration (p = 0.029). Six-month mortality was 0% versus 10.7% (p = 0.091). CONCLUSION: Adjunctive tofacitinib was associated with significant glucocorticoid-sparing effects in DRESS. Prospective randomized controlled trials are needed for validation.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.