{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T04:07:06Z","timestamp":1778990826702,"version":"3.51.4"},"reference-count":11,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Immune checkpoint inhibitor (ICI) therapies are known to cause immune\u2010related adverse events (irAEs), including life\u2010threatening myocarditis, myositis, and myasthenia (MMM) overlap syndrome. Current literature lacks established therapeutic guidelines for effective management with steroid\u2010sparing agents. In this paper, we report the successful treatment of MMM with baricitinib in conjunction with abatacept (CTLA\u20104\u2010Ig) in a single patient. We report two cases with a history of locally advanced malignancies treated surgically who were receiving adjuvant ICI therapy and subsequently developed MMM overlap syndrome. Case A was treated with high\u2010dose corticosteroids, IVIG, and mycophenolate mofetil with no improvement and subsequently expired due to respiratory failure and cardiac arrest. On the other hand, Case B showed improvement of myocarditis and myositis with high\u2010dose corticosteroids, abatacept, and mycophenolate mofetil. However, myasthenic symptoms progressed. Discontinuation of mycophenolate mofetil and initiation of baricitinib resulted in a complete recovery at 2\u2010month follow\u2010up. The use of baricitinib in combination with abatacept resulted in significant improvement of ICI\u2010induced MMM in our patient. We propose that in patients with ICI\u2010induced MMM, baricitinib with abatacept can be used effectively with successful outcomes, especially for refractory myasthenic symptoms. Further clinical trials on the use of JAK inhibitors alone or in combination with abatacept will be beneficial in determining its efficacy.<\/jats:p>","DOI":"10.1002\/ccr3.72707","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T04:01:13Z","timestamp":1778558473000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Successful Treatment of Immune Checkpoint Inhibitor\u2010Induced Myocarditis, Myositis, and Myasthenia Overlap Syndrome With Baricitinib and Abatacept"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9089-6629","authenticated-orcid":false,"given":"Zeinab","family":"Alnahas","sequence":"first","affiliation":[{"name":"Tucson Medical Center  Tucson Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sujata","family":"Sarkar","sequence":"additional","affiliation":[{"name":"Tucson Medical Center  Tucson Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oishi","family":"Roychoudhury","sequence":"additional","affiliation":[{"name":"SUNY Upstate Medical University  New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ernest","family":"Algabre","sequence":"additional","affiliation":[{"name":"Tucson Medical Center  Tucson Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"issue":"6","key":"e_1_2_10_2_1","first-page":"732","article-title":"Severe vs Nonsevere Immune Checkpoint Inhibitor\u2010Induced Myocarditis: Contemporary 1\u2010Year Outcomes","volume":"5","author":"Itzhaki Ben Zadok O.","year":"2023","journal-title":"Cardio Oncology"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics14161794"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-022-05368-8"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000200177"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/onco.13931"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30533-6"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1609214"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-018-0878-7"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.8968"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1158\/2159-8290.CD-22-1180"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcr\/ytaf019"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72707","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.72707","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72707","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T04:01:34Z","timestamp":1778990494000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.72707"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":11,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/ccr3.72707"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.72707","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2025-12-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e72707"}}