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Topical ruxolitinib is promising as sole or adjunctive therapy in treating maculopapular rash of acute and chronic skin GVHD

Bone Marrow Transplantation volume 59, pages 425–427 (2024)Cite this article

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Graft-versus-host disease (GVHD) contributes to significant morbidity and non-relapse mortality in patients who have received an allogeneic hematopoietic stem cell transplant (HSCT) [1,2,3] or solid organ transplant (SOT). GVHD in SOT carries high risk of mortality despite similar pathophysiology. Topical and systemic steroids are the mainstay of therapy for cutaneous GVHD, but these have associated toxicity and may not completely treat GVHD [4]. Once deemed steroid-refractory, additional systemic therapies or extracorporeal photopheresis are indicated.

Ruxolitinib is a Janus Kinase (JAK) 1/2 inhibitor with efficacy in the systemic treatment of steroid refractory acute and chronic GVHD in allogeneic HSCT recipients aged ≥ 12 years [5,6,7]. Topical ruxolitinib 1.5% cream (Opzelura™) is currently FDA approved for treatment of mild-moderate atopic dermatitis and non-segmental vitiligo [8, 9]. Markova et al. have reported efficacy of topical ruxolitinib in treatment of predominantly chronic non-sclerotic skin GVHD in patients ≥12 years of age [10].

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Acknowledgements

We would like to thank clinical staff, patients, and families at Cincinnati Children’s Hospital Medical Center.

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Authors and Affiliations

  1. Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, 45229, USA

    Zahra Hudda, Amanda Flannery, Ashley Teusink-Cross, Stella M. Davies & Pooja Khandelwal

  2. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, 45229, USA

    Zahra Hudda, Stella M. Davies & Pooja Khandelwal

  3. Division of Pharmacy, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, 45229, USA

    Ashley Teusink-Cross

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  1. Zahra Hudda
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  5. Pooja Khandelwal
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Contributions

ZH and PK designed the study, collected data, and wrote the manuscript. ATC contributed to analyzing, interpreting results, reviewing the manuscript critically for edits. AF and SMD contributed patients and reviewed the manuscript critically for edits.

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Correspondence to Zahra Hudda.

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Hudda, Z., Flannery, A., Teusink-Cross, A. et al. Topical ruxolitinib is promising as sole or adjunctive therapy in treating maculopapular rash of acute and chronic skin GVHD. Bone Marrow Transplant 59, 425–427 (2024). https://doi.org/10.1038/s41409-023-02181-3

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