Eye (London, England) · 2025
The use of Janus kinase inhibitors to treat noninfectious uveitis.
СтатьяНазвание и аннотация: Перевод в очереди
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Beckman Madeline, Srivastava Sunil K, Lowder Careen Y, Baynes Kim, Lowe Ashley, Sharma Sumit
Аннотация
OBJECTIVE: To present a case series of eight patients with noninfectious chronic uveitis treated at a single institution with one of two JAK inhibitors (Jakinibs), upadacitinib or tofacitinib.
SUBJECTS/METHODS: A retrospective chart review of patients seen by the uveitis service from 2015 to 2022 treated with upadacitinib and/or tofacitinib was performed. All patients included had previously failed alternative immunomodulatory therapy (IMT), had consistent ophthalmic evaluations for at least 6 months, and stayed on the Jakinib for at least 3 months. Eight patients were included. Demographic information was collected. Flares were classified clinically through visual acuity, symptoms, examination, and imaging. Side effects of the Jakinibs were recorded.
RESULTS: The median length of Jakinib therapy duration was 29.5 months (range 6 months-43 months). Five patients were initiated on a Jakinib due to poor control of their ocular inflammatory diseases. Four of these patients achieved control with tofacitinib with or without additional steroid use; one patient achieved control with upadacitinib with one mild flare that resolved with systemic steroid use. Three patients started a Jakinib due to poor systemic disease control. Two of those remained flare-free of uveitis in the following year. The third patient had a flare that resolved with topical and oral therapy. Gastrointestinal upset was the most common side effect of tofacitinib. Upadacitinib had no reported side effects.
CONCLUSION: Jakinibs may have a role in treatment of refractory noninfectious uveitis after failing conventional IMT. Both Jakinibs were well tolerated with a low incidence of side effects.
SUBJECTS/METHODS: A retrospective chart review of patients seen by the uveitis service from 2015 to 2022 treated with upadacitinib and/or tofacitinib was performed. All patients included had previously failed alternative immunomodulatory therapy (IMT), had consistent ophthalmic evaluations for at least 6 months, and stayed on the Jakinib for at least 3 months. Eight patients were included. Demographic information was collected. Flares were classified clinically through visual acuity, symptoms, examination, and imaging. Side effects of the Jakinibs were recorded.
RESULTS: The median length of Jakinib therapy duration was 29.5 months (range 6 months-43 months). Five patients were initiated on a Jakinib due to poor control of their ocular inflammatory diseases. Four of these patients achieved control with tofacitinib with or without additional steroid use; one patient achieved control with upadacitinib with one mild flare that resolved with systemic steroid use. Three patients started a Jakinib due to poor systemic disease control. Two of those remained flare-free of uveitis in the following year. The third patient had a flare that resolved with topical and oral therapy. Gastrointestinal upset was the most common side effect of tofacitinib. Upadacitinib had no reported side effects.
CONCLUSION: Jakinibs may have a role in treatment of refractory noninfectious uveitis after failing conventional IMT. Both Jakinibs were well tolerated with a low incidence of side effects.