A novel pitch against the itch

About 25% of patients suffering from chronic spontaneous urticaria (CSU) are refractory to first-line therapy, making treatment challenging in these cases. There are limited options in the treatment ladder for urticaria as omalizumab is more effective in patients with raised immunoglobulin E levels; also, cost and feasibility of administration are limiting factors. Dose-related side effects often limit cyclosporine’s greater efficacy. We started tofacitinib for our 68-year-old patient who had been suffering from refractory CSU for the past 12 years and observed quick control of signs and symptoms starting within 2 weeks and good long-term control for over 9 months of which last 6 months were monotherapy.