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JAK inhibitors in refractory juvenile idiopathic arthritis-associated uveitis

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Abstract

To present our preliminary experience with JAK inhibitors in treating patients affected by juvenile idiopathic arthritis (JIA) and associated uveitis. Case series. Four consecutive patients with long-term history of juvenile idiopathic arthritis and severe associated uveitis were included in the study. Indication for treatment with JAK inhibitors was uncontrolled arthritis and/or uveitis despite different treatments with conventional and biologic disease modifying antirheumatic drugs (DMARDs). While on treatment with JAK inhibitors, namely, baricitinib (three cases) and tofacitinib (one case), all our patients showed improvement of uveitis defined as a reduction of intraocular inflammation according to Standardized Uveitis Nomenclature criteria. However, we observed a different response to treatment between the uveitis and the articular disease, as the latter did not respond as favorably as the former. Overall, the treatment was well tolerated by all patients and no ocular discomfort, ocular side effects, or allergic reactions were registered. JAK inhibitors may provide a new valuable treatment option in the therapeutic armamentarium for patients affected with JIA-associated uveitis, particularly in those refractory cases that are not adequately responding to conventional or biologic DMARDs.

Key Points

• A subset of patients with JIA uveitis either remain unresponsive or experience loss of efficacy

• JAK inhibitors may provide a new valuable treatment option in JIA patients with uveitis

• The safety profile was good with no occurrence of systemic side effects

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Authors and Affiliations

  1. Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy

    Elisabetta Miserocchi & Chiara Giuffrè

  2. Pediatric Rheumatology Unit, ASST G. Pini-CTO, Piazza Cardinale Andrea Ferrari 1, 20122, Milan, Italy

    Martina Cornalba, Irene Pontikaki & Rolando Cimaz

  3. Department of Clinical Sciences and Community Health, University of Milan, Via Festa del Perdono, 7, 20122, Milan, MI, Italy

    Rolando Cimaz

Authors
  1. Elisabetta Miserocchi
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  2. Chiara Giuffrè
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  3. Martina Cornalba
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  4. Irene Pontikaki
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  5. Rolando Cimaz
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Correspondence to Elisabetta Miserocchi.

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Miserocchi, E., Giuffrè, C., Cornalba, M. et al. JAK inhibitors in refractory juvenile idiopathic arthritis-associated uveitis. Clin Rheumatol 39, 847–851 (2020). https://doi.org/10.1007/s10067-019-04875-w

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  • DOI: https://doi.org/10.1007/s10067-019-04875-w

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