AUTHOR=Vitale Antonio , Palacios-Olid Judith , Caggiano Valeria , Ragab Gaafar , Hernández-Rodríguez José , Pelegrín Laura , Mejía-Salgado Germán , Zarate-Pinzón Laura , Gentileschi Stefano , Sota Jurgen , Fonollosa Alex , Carreño Ester , Gaggiano Carla , Amin Rana Hussein , Balistreri Alberto , Narváez Javier , Tosi Gian Marco , Frediani Bruno , Cantarini Luca , de-la-Torre Alejandra , Fabiani Claudia 

TITLE=Efficacy and safety of Janus kinase inhibitors in non-infectious inflammatory ocular diseases: a prospective cohort study from the international AIDA network registries

JOURNAL=Frontiers in Medicine

VOLUME=11

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1439338

DOI=10.3389/fmed.2024.1439338

ISSN=2296-858X

ABSTRACT=<sec><title>Introduction</title><p>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.</p></sec><sec><title>Methods</title><p>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.</p></sec><sec><title>Results</title><p>Ocular inflammation was related to a systemic disease in 8 (66.7%) patients as follows: spondyloarthritis (<italic>n</italic> = 3), peripheral psoriatic arthritis (<italic>n</italic> = 1), rheumatoid arthritis (<italic>n</italic> = 1), antinuclear antibodies (ANA) positive juvenile idiopathic arthritis (<italic>n</italic> = 1), Behçet’s syndrome (<italic>n</italic> = 1), Vogt-Koyanagi-Harada syndrome (<italic>n</italic> = 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% CI 1.3–14.7, <italic>p</italic>-value: 0.02).</p></sec><sec><title>Conclusion</title><p>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.</p></sec>