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Cutaneous sarcoidosis — a notoriously hard-to-treat skin condition — may finally have a worthy contender. A phase II trial found that brepocitinib, a TYK2/JAK1 inhibitor already FDA-approved for dermatomyositis, produced dramatic improvements in disease activity scores compared to placebo, with no serious adverse effects. A larger phase III trial is now underway, with results expected by end of 2028.
Cutaneous sarcoidosis has long been one of dermatology's toughest treatment challenges — corticosteroids work only sporadically, second-line agents offer little improvement, and even TNF inhibitors come with high relapse and discontinuation rates. But a new phase II trial is offering real hope. Brepocitinib (Lisraya), a dual-acting TYK2/JAK1 inhibitor recently FDA-approved for dermatomyositis, delivered striking results in 31 patients with cutaneous sarcoidosis, with findings published in JAMA Dermatology and presented at the American College of Rheumatology annual meeting.
Patients on either dose of brepocitinib achieved an average 22-point reduction in disease activity scores after 16 weeks — far exceeding the 5-point threshold for clinical relevance — while the placebo group saw no improvement at all. Notably, all five patients with lupus pernio (a particularly disfiguring facial manifestation) on the higher dose achieved meaningful reductions. No serious adverse events were recorded.
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Why it matters: With no truly effective therapy currently available, brepocitinib could become the first meaningful treatment advance for cutaneous sarcoidosis in decades — and the lead investigator suggests it could even become a first-line option if phase III data hold up.
