Case report: Successful treatment of anti‐MDA5‐positive to negative dermatomyositis‐associated interstitial lung disease with the JAK inhibitor tofacitinib

Abstract

Objective: Anti-MDA5 antibody-positive dermatomyositis (DM) is a rare clinical autoimmune disease, and anti-MDA5-positive DM with interstitial lung disease (ILD) is the most important cause of death in DM patients. We reported the efficacy of the JAK1/3 inhibitor tofacitinib as an anti-MDA5negative treatment option for patients with anti-MDA5-positive DM-ILD. Method and process: Here we report a 51-year-old female patient with cough, sputum, shortness of breath for 5 months, rash for 3 months, and muscle pain in the extremities for 1 month. After conventional immunosuppressive therapy plus hormone therapy, the remission was slow.Methylprednisolone was successfully reduced after we administered tofacitinib and tacrolimus. After 132 weeks of follow-up, anti-MDA5 antibody turned negative, clinical symptoms were relieved, and lung Imaging tests were successfully reversed. Results and Conclusion:There is currently no report of tofacitinib supplement therapy for anti-MDA5 positive to negative DM. With this case report, tofacitinib is an option for the treatment of anti-MDA5-positive DM-ILD, which deserves attention.

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

“…2. A total of 21 articles, including 79 cases, were identified [5,6,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. Although Shirai et al [8] reported 13 patients treated with tofacitinib, only 8 patients were included in our analysis because data of the other 5 patients were combined with those treated without tofacitinib.…”