{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T20:33:01Z","timestamp":1789590781784,"version":"build-2803163510"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,2,22]],"date-time":"2025-02-22T00:00:00Z","timestamp":1740182400000},"content-version":"vor","delay-in-days":21,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats: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.<\/jats:p>","DOI":"10.1093\/omcr\/omae199","type":"journal-article","created":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T08:06:25Z","timestamp":1733817985000},"source":"Crossref","is-referenced-by-count":6,"title":["Efficacy of Upadacitinib in refractory Polyarteritis Nodosa: a case report"],"prefix":"10.1093","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4069-2921","authenticated-orcid":false,"given":"Akihiko","family":"Nakabayashi","sequence":"first","affiliation":[{"name":"Department of Rheumatology, NHO Osaka Minami Medical Center , 2-1 Kidohigashi, Kawachinagano, Osaka 586-8521 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Iguchi","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, NHO Osaka Minami Medical Center , 2-1 Kidohigashi, Kawachinagano, Osaka 586-8521 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong Seop","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, NHO Osaka Minami Medical Center , 2-1 Kidohigashi, Kawachinagano, Osaka 586-8521 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanakawee","family":"Siripongvutikorn","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, NHO Osaka Minami Medical Center , 2-1 Kidohigashi, Kawachinagano, Osaka 586-8521 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Nishigaichi","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, NHO Osaka Minami Medical Center , 2-1 Kidohigashi, Kawachinagano, Osaka 586-8521 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maiko","family":"Yoshimura","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, NHO Osaka Minami Medical Center , 2-1 Kidohigashi, Kawachinagano, Osaka 586-8521 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyota","family":"Takamatsu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, NHO Osaka Minami Medical Center , 2-1 Kidohigashi, Kawachinagano, Osaka 586-8521 ,","place":["Japan"]},{"name":"Department of Clinical Research\/Rheumatology, NHO Osaka Minami Medical Center , 2-1 Kidohigashi, Kawachinagano, Osaka 586-8521 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiro","family":"Ohshima","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, NHO Osaka Minami Medical Center , 2-1 Kidohigashi, Kawachinagano, Osaka 586-8521 ,","place":["Japan"]},{"name":"Department of Clinical Research, NHO Osaka Minami Medical Center , 2-1 Kidohigashi, Kawachinagano, Osaka 586-8521 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,2,22]]},"reference":[{"key":"2025022206262055400_ref1","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1016\/j.jaut.2014.01.029","article-title":"Diagnosis and classification of polyarteritis nodosa","volume":"48-49","author":"Hern\u00e1ndez-Rodr\u00edguez","year":"2014","journal-title":"J Autoimmun"},{"key":"2025022206262055400_ref2","doi-asserted-by":"publisher","first-page":"1384","DOI":"10.1002\/art.41776","article-title":"2021 American College of Rheumatology\/Vasculitis foundation guideline for the management of polyarteritis nodosa","volume":"73","author":"Chung","year":"2021","journal-title":"Arthritis Rheumatol"},{"key":"2025022206262055400_ref3","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1136\/ard.2006.054593","article-title":"Development and validation of a consensus methodology for the classification of the ANCA-associated vasculitides and polyarteritis nodosa for epidemiological studies","volume":"66","author":"Watts","year":"2007","journal-title":"Ann Rheum Dis"},{"key":"2025022206262055400_ref4","doi-asserted-by":"publisher","first-page":"322","DOI":"10.2340\/00015555-1228","article-title":"Serum levels of interleukin-6 in patients with cutaneous polyarteritis nodosa","volume":"92","author":"Kawakami","year":"2012","journal-title":"Acta Derm Venereol"},{"key":"2025022206262055400_ref5","doi-asserted-by":"publisher","first-page":"e204","DOI":"10.1136\/annrheumdis-2020-218710","article-title":"Tocilizumab for the treatment of polyarteritis nodosa: a systematic literature review. Correspondence on \u2018Tofacitinib for polyarteritis nodosa: a tailored therapy\u2019 by Rimar et\u00a0al","volume":"81","author":"Akiyama","year":"2022","journal-title":"Ann Rheum Dis"},{"key":"2025022206262055400_ref6","doi-asserted-by":"publisher","first-page":"2214","DOI":"10.1136\/annrheumdis-2016-209330","article-title":"Tofacitinib for polyarteritis nodosa: a tailored therapy","volume":"75","author":"Rimar","year":"2016","journal-title":"Ann Rheum Dis"},{"key":"2025022206262055400_ref7","doi-asserted-by":"publisher","first-page":"rkad049","DOI":"10.1093\/rap\/rkad049","article-title":"Tofacitinib as monotherapy in cutaneous polyarteritis nodosa: a case series","volume":"7","author":"Roy","year":"2023","journal-title":"Rheumatol Adv Pract"},{"key":"2025022206262055400_ref8","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.695768","article-title":"Tofacitinib treatment of refractory cutaneous leukocytoclastic vasculitis: a case report","volume":"12","author":"Zhu","year":"2021","journal-title":"Front Immunol"},{"key":"2025022206262055400_ref9","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1186\/s13075-022-02744-7","article-title":"Preferable outcome of Janus kinase inhibitors for a group of difficult-to-treat rheumatoid arthritis patients: from the FIRST registry","volume":"24","author":"Ochi","year":"2022","journal-title":"Arthritis Res Ther"}],"container-title":["Oxford Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/omcr\/article-pdf\/2025\/2\/omae199\/62049720\/omae199.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/omcr\/article-pdf\/2025\/2\/omae199\/62049720\/omae199.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,22]],"date-time":"2025-02-22T01:26:33Z","timestamp":1740187593000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/omcr\/article\/doi\/10.1093\/omcr\/omae199\/8029948"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":9,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2,22]]}},"URL":"https:\/\/doi.org\/10.1093\/omcr\/omae199","relation":{},"ISSN":["2053-8855"],"issn-type":[{"value":"2053-8855","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,2]]},"published":{"date-parts":[[2025,2]]},"article-number":"omae199"}}