Efficacy and safety of dose escalation of tofacitinib in refractory anti-MDA5 antibody-positive dermatomyositis
Authors' conclusion
These cases suggest that the dose escalation of tofacitinib can be an option for MDA5-DM patients refractory to 10 mg/day of tofacitinib and other immunosuppressants although the risk of infection is a concern.
Study context
- Population
- Anti-MDA5 antibody-positive DM with rapidly progressive-interstitial lung disease (RP-ILD) refractory to triple therapy (high-dose GC, CYC and tacrolimus) followed by tofacitinib 10 mg/day
- Participants
- 6 participants
- Outcome
- Improvement after dose escalation of tofacitinib
Main finding
As reported in the abstract
Tofacitinib dose escalation
4
events
- Two non-responders died
- 2
Observational data: associations, not effects.
Safety
| Outcome | Values |
|---|---|
| At least one infection | Tofacitinib dose escalation 6 events |
- At least one infection — Cytomegalovirus reactivation
- 5
- At least one infection — Pulmonary aspergillosis
- 1
- At least one infection — Herpes zoster
- 1
- At least one infection — Herpes simplex keratitis
- 1
Original publication
Efficacy and safety of dose escalation of tofacitinib in refractory anti-MDA5 antibody-positive dermatomyositis. RMD Open. Published 2 January 2023. doi:10.
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