{"title":"Efficacy of Upadacitinib in refractory Polyarteritis Nodosa: a case report.","authors":"Akihiko Nakabayashi, Erika Iguchi, Dong Seop Kim, Yanakawee Siripongvutikorn, Akira Nishigaichi, Maiko Yoshimura, Hyota Takamatsu, Shiro Ohshima","doi":"10.1093/omcr/omae199","DOIUrl":null,"url":null,"abstract":"<p><p>Polyarteritis nodosa (PAN) is systemic vasculitis, typically treated with a combination of glucocorticoids and immunosuppressants. Changing the immunosuppressant is recommended if remission cannot be achieved with these treatments. However, there is a lack of further treatment options for patients who are unresponsive to all immunosuppressants. We report a 44-year-old Japanese man with refractory PAN who was unresponsive to various immunosuppressants (including tocilizumab). Upadacitinib treatment led to relatively rapid symptom improvement, allowing for tapering and eventual discontinuation of immunosuppressants, including prednisolone. During his 1-year follow-up, no relapse or side effects were noted. This case suggests that Janus kinase inhibitors may provide a breakthrough for patients with refractory PAN.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2025 2","pages":"omae199"},"PeriodicalIF":0.5000,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845599/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Oxford Medical Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/omcr/omae199","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
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Abstract
Polyarteritis nodosa (PAN) is systemic vasculitis, typically treated with a combination of glucocorticoids and immunosuppressants. Changing the immunosuppressant is recommended if remission cannot be achieved with these treatments. However, there is a lack of further treatment options for patients who are unresponsive to all immunosuppressants. We report a 44-year-old Japanese man with refractory PAN who was unresponsive to various immunosuppressants (including tocilizumab). Upadacitinib treatment led to relatively rapid symptom improvement, allowing for tapering and eventual discontinuation of immunosuppressants, including prednisolone. During his 1-year follow-up, no relapse or side effects were noted. This case suggests that Janus kinase inhibitors may provide a breakthrough for patients with refractory PAN.
期刊介绍：
Oxford Medical Case Reports (OMCR) is an open access, peer-reviewed online journal publishing original and educationally valuable case reports that expand the field of medicine. The journal covers all medical specialities including cardiology, rheumatology, nephrology, oncology, neurology, and reproduction, comprising a comprehensive resource for physicians in all fields and at all stages of training. Oxford Medical Case Reports deposits all articles in PubMed Central (PMC). Physicians and researchers can find your work through PubMed , helping you reach the widest possible audience. The journal is also indexed in the Web of Science Core Collection . Oxford Medical Case Reports publishes case reports under the following categories: Allergy Audiovestibular medicine Cardiology and cardiovascular systems Critical care medicine Dermatology Emergency medicine Endocrinology and metabolism Gastroenterology and hepatology Geriatrics and gerontology Haematology Immunology Infectious diseases and tropical medicine Medical disorders in pregnancy Medical ophthalmology Nephrology Neurology Oncology Paediatrics Pain Palliative medicine Pharmacology and pharmacy Psychiatry Radiology, nuclear medicine, and medical imaging Respiratory disorders Rheumatology Sexual and reproductive health Sports Medicine Substance abuse.
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