Baricitinib for anti-melanoma differentiation-associated protein 5 antibody-positive dermatomyositis-associated interstitial lung disease : a case series and literature review on Janus kinase inhibitors for the disease
© 2024. The Author(s)..
Anti-melanoma differentiation-associated protein 5 antibody-positive dermatomyositis (anti-MDA5-DM) is frequently complicated by progressive interstitial lung disease (ILD), the prognosis of which is poor, and management is a major challenge. We treated three patients with anti-MDA5-DM-associated ILD (anti-MDA5-DM-ILD) using the Janus kinase (JAK) inhibitor, baricitinib, which improved lung opacities and saved two patients. We reviewed 6 patients with anti-MDA5-DM-ILD who had been treated with tofacitinib at our institution. Five of the patients survived, although discontinuation of tofacitinib due to complications was frequently observed. In addition, a literature search of patients with anti-MDA5-DM-ILD who were treated with JAK inhibitors yielded 21 articles involving 79 cases. All patients except one were treated with tofacitinib, and the survival rate was 75.9%. Although not statistically confirmed, the deceased patients tended to be older and had higher ferritin levels. A total of 92 complications were observed, 11 of which resulted in JAK inhibitor discontinuation. Cytomegalovirus reactivation comprised a substantial percentage of all complications and of those patients who required JAK inhibitor discontinuation. Five cases with fatal infective complications were also observed. While tofacitinib has been proposed to be a therapeutic option for anti-MDA5-DM-ILD, other JAK inhibitors, including baricitinib, are a treatment option. Further investigation is warranted to optimize treatment of anti-MDA5-DM-ILD.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:44 |
|---|---|
| Enthalten in: |
Rheumatology international - 44(2024), 5 vom: 08. Apr., Seite 961-971 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Harada, Hiroaki [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 01.04.2024 Date Revised 01.04.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s00296-024-05551-2 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM369466446 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM369466446 | ||
| 003 | DE-627 | ||
| 005 | 20240401232738.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240308s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s00296-024-05551-2 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1359.xml |
| 035 | |a (DE-627)NLM369466446 | ||
| 035 | |a (NLM)38456909 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Harada, Hiroaki |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Baricitinib for anti-melanoma differentiation-associated protein 5 antibody-positive dermatomyositis-associated interstitial lung disease |b a case series and literature review on Janus kinase inhibitors for the disease |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 01.04.2024 | ||
| 500 | |a Date Revised 01.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024. The Author(s). | ||
| 520 | |a Anti-melanoma differentiation-associated protein 5 antibody-positive dermatomyositis (anti-MDA5-DM) is frequently complicated by progressive interstitial lung disease (ILD), the prognosis of which is poor, and management is a major challenge. We treated three patients with anti-MDA5-DM-associated ILD (anti-MDA5-DM-ILD) using the Janus kinase (JAK) inhibitor, baricitinib, which improved lung opacities and saved two patients. We reviewed 6 patients with anti-MDA5-DM-ILD who had been treated with tofacitinib at our institution. Five of the patients survived, although discontinuation of tofacitinib due to complications was frequently observed. In addition, a literature search of patients with anti-MDA5-DM-ILD who were treated with JAK inhibitors yielded 21 articles involving 79 cases. All patients except one were treated with tofacitinib, and the survival rate was 75.9%. Although not statistically confirmed, the deceased patients tended to be older and had higher ferritin levels. A total of 92 complications were observed, 11 of which resulted in JAK inhibitor discontinuation. Cytomegalovirus reactivation comprised a substantial percentage of all complications and of those patients who required JAK inhibitor discontinuation. Five cases with fatal infective complications were also observed. While tofacitinib has been proposed to be a therapeutic option for anti-MDA5-DM-ILD, other JAK inhibitors, including baricitinib, are a treatment option. Further investigation is warranted to optimize treatment of anti-MDA5-DM-ILD | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Anti-MDA5 antibody-positive dermatomyositis | |
| 650 | 4 | |a Baricitinib | |
| 650 | 4 | |a Interstitial lung disease | |
| 650 | 4 | |a JAK inhibitors | |
| 650 | 4 | |a Tofacitinib | |
| 650 | 7 | |a Janus Kinase Inhibitors |2 NLM | |
| 650 | 7 | |a baricitinib |2 NLM | |
| 650 | 7 | |a ISP4442I3Y |2 NLM | |
| 650 | 7 | |a Autoantibodies |2 NLM | |
| 650 | 7 | |a Interferon-Induced Helicase, IFIH1 |2 NLM | |
| 650 | 7 | |a EC 3.6.4.13 |2 NLM | |
| 650 | 7 | |a Azetidines |2 NLM | |
| 650 | 7 | |a Purines |2 NLM | |
| 650 | 7 | |a Pyrazoles |2 NLM | |
| 650 | 7 | |a Sulfonamides |2 NLM | |
| 700 | 1 | |a Shoda, Hirofumi |e verfasserin |4 aut | |
| 700 | 1 | |a Tsuchiya, Haruka |e verfasserin |4 aut | |
| 700 | 1 | |a Misaki, Makoto |e verfasserin |4 aut | |
| 700 | 1 | |a Sawada, Takayuki |e verfasserin |4 aut | |
| 700 | 1 | |a Fujio, Keishi |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Rheumatology international |d 1985 |g 44(2024), 5 vom: 08. Apr., Seite 961-971 |w (DE-627)NLM012644315 |x 1437-160X |7 nnns |
| 773 | 1 | 8 | |g volume:44 |g year:2024 |g number:5 |g day:08 |g month:04 |g pages:961-971 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s00296-024-05551-2 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 44 |j 2024 |e 5 |b 08 |c 04 |h 961-971 | ||