Efficacy of Janus activated kinase (JAK) inhibitors in the treatment of ocular autoimmune disorders
Purpose
Janus activated kinases (JAKs) have emerged as a new therapeutics for autoimmune inflammatory diseases. Up to date information on their efficacy in ocular inflammation is scarce. Herein we report on 12 patients with ocular autoimmune disorders and their treatment response to JAK inhibitor therapy.
Methods
Retrospective cohort study on 12 patients with ocular inflammation treated with JAK inhibitors between December 2020 and March 2023 at the Department of Ophthalmology, Charité Berlin.
Results
Majority of patients presented with anterior uveitis (5 patients), followed by posterior uveitis (3 patients), intermediate uveitis, mucous membrane pemphigoid, anterior scleritis, Mooren’s ulcer (each 1 patient). Associated systemic autoimmune disorders were ankylosing spondylitis (4 patients), juvenile idiopathic arthritis (2 patients), rheumatoid arthritis and psoriatic arthritis (each 1 patient). All patients have received multiple systemic therapies with persistent ocular and/or systemic inflammation before the switch. After a median (IQR) treatment time of 13 (4.5 – 15.5) months inflammation improved in 6 patients (3 anterior uveitis, 1 MMP, 1 scleritis, 1 Mooren’s ulcer), of which 50% presented with systemic autoimmune disorders. Inflammation was unchanged in 2 and worsened in 4 patients (3 posterior, 1 intermediate, 2 anterior uveitis) and all patients had associated systemic disease. Of note 4 of these patients developed macular edema which necessitated intravitreal steroid injections.
Conclusion
Our preliminary experience with JAK inhibitors suggests a favourable response of anterior segment or ocular surface disorders, while they seem to be less effective in intermediate or posterior uveitis.
Conflict of interest
No
Authors 1
Last name
RüBSAM
Initials of first name(s)
Anne
Department
Department of Ophthalmology, Charité Universitätsmedizin Berlin
City
Berlin
Country
Germany
Authors 2
Last name
Pohlmann
Initials of first name(s)
Dominika
Department
Department of Ophthalmology, Charité Universitätsmedizin Berlin
City
Berlin
Country
Germany
Authors 3
Last name
zur Bonsen
Initials of first name(s)
Lynn
Department
Department of Ophthalmology, Charité Universitätsmedizin Berlin
City
Berlin
Country
Germany
Authors 4
Last name
Pleyer
Initials of first name(s)
Uwe
Department
Department of Ophthalmology, Charité Universitätsmedizin Berlin
City
Berlin
Country
Germany
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