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ORIGINAL RESEARCH article

Front. Med.
Sec. Rheumatology
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1439338

Efficacy and Safety of Janus Kinase Inhibitors in Non-Infectious Inflammatory Ocular Diseases: A Prospective Cohort Study from the International AIDA Network Registries

Provisionally accepted
Antonio Vitale Antonio Vitale 1Judith Palacios-Olid Judith Palacios-Olid 2Valeria Caggiano Valeria Caggiano 1Gaafar Ragab Gaafar Ragab 3José Hernández-Rodríguez José Hernández-Rodríguez 4Laura Pelegrín Colás Laura Pelegrín Colás 4Germán Mejía-Salgado Germán Mejía-Salgado 5Laura Zarate-Pinzón Laura Zarate-Pinzón 5Stefano Gentileschi Stefano Gentileschi 1Jurgen Sota Jurgen Sota 1Alex Fonollosa Alex Fonollosa 6Ester Carreño Ester Carreño 7Carla Gaggiano Carla Gaggiano 1Rana Amin Rana Amin 3Alberto Balistreri Alberto Balistreri 1Javier Narvaez Javier Narvaez 2Gian Marco Tosi Gian Marco Tosi 1Bruno Frediani Bruno Frediani 1Luca Cantarini Luca Cantarini 1*Alejandra de-la-Torre Alejandra de-la-Torre 5Claudia Fabiani Claudia Fabiani 1
  • 1 University of Siena, Siena, Italy
  • 2 L'Hospitalet de Llobregat, Barcelona, Catalonia, Spain
  • 3 Cairo University, Giza, Giza, Egypt
  • 4 Hospital Clinic of Barcelona, Barcelona, Catalonia, Spain
  • 5 Rosario University, Bogotá, Bogota, Colombia
  • 6 University of the Basque Country, Bilbao, Basque Country, Spain
  • 7 Hospital Universitario Rey Juan Carlos, Madrid, Madrid, Spain

The final, formatted version of the article will be published soon.

    Introduction: Non-infectious inflammatory ocular diseases pose significant challenges in diagnosis and management, often requiring systemic immunosuppressive therapy. Since Janus kinase (JAK) inhibitors may represent a novel therapeutic option for these disorders, the present study aimed to expand current knowledge about their efficacy and safety in patients with these conditions. Methods: This prospective cohort study included 12 adult patients from the international Autoinflammatory Disease Alliance (AIDA) Network registries dedicated to non-infectious ocular inflammatory conditions. We assessed ocular flares, visual acuity, disease course, and complications before and after initiating JAK inhibitor therapy. Results: Ocular inflammation was related to a systemic disease in 8 (66.7%) patients as follows: spondyloarthritis (n=3), peripheral psoriatic arthritis (n=1), rheumatoid arthritis (n=1), antinuclear antibodies (ANA) positive juvenile idiopathic arthritis (n=1), Behçet’s syndrome (n=1), Vogt-Koyanagi-Harada syndrome (n=1). In total, 4 patients received baricitinib, 1 patient received tofacitinib, and 7 patients underwent upadacitinib treatment. The overall average duration of JAK inhibitors treatment was 8.6±5.5 months (ranging from 3 to 20 months). At the last assessment, ocular disease control was complete in 12/12 patients. One patient discontinued baricitinib due to poor compliance after a 12-month relapse-free period. The incidence of ocular flares was 125 episodes/1.000 person-months prior to the initiation of JAK inhibitors and 28.6 episodes/1.000 person-months thereafter. The incidence rate ratio for experiencing a relapse before starting a JAK inhibitor compared to the following period was 4.37 (95% C.I. 1.3-14.7, p-value: 0.02). Conclusion: JAK inhibitors demonstrate efficacy and safety in controlling ocular inflammatory relapses, confirming that they represent a valuable treatment option for patients with non-infectious inflammatory ocular diseases resistant to conventional treatments.

    Keywords: Baricitinib, Scleritis, Tofacitinib, Upadacitinib, Uveitis

    Received: 27 May 2024; Accepted: 29 Jul 2024.

    Copyright: © 2024 Vitale, Palacios-Olid, Caggiano, Ragab, Hernández-Rodríguez, Pelegrín Colás, Mejía-Salgado, Zarate-Pinzón, Gentileschi, Sota, Fonollosa, Carreño, Gaggiano, Amin, Balistreri, Narvaez, Tosi, Frediani, Cantarini, de-la-Torre and Fabiani. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Luca Cantarini, University of Siena, Siena, Italy

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.