{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T12:33:07Z","timestamp":1793363587539,"version":"4.5.0"},"reference-count":20,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T00:00:00Z","timestamp":1705622400000},"content-version":"unspecified","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2024,1,3]]},"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To evaluate the effectiveness and safety of upadacitinib in treatment-refractory inflammatory myositis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients with refractory inflammatory myositis treated with upadacitinib from a single urban centre in Vancouver, British Columbia, Canada, were included from September 2020 to June 2023. The medical records of these patients were retrospectively reviewed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>10 total patients were identified for review, including 5 classic dermatomyositis (DM), 3 amyopathic DM (ADM) and 2 antisynthetase syndrome. The patients failed an average of four immunosuppressants before initiation of upadacitinib. Three had prior Janus kinase inhibitor therapy with tofacitinib. In the classic DM and ADM aggregate group, upadacitinib offered clinically and statistically significant cutaneous improvement. Lack of active muscle disease at baseline precluded analysis of the effect of upadacitinib on muscle weakness. Nine patients remained on upadacitinib at the end of the study period. One patient discontinued upadacitinib due to severe facial acne.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Upadacitinib appears to be effective in targeting cutaneous manifestations of refractory inflammatory DM. Further research is still needed to validate its efficacy on a broader population scale.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2023-003837","type":"journal-article","created":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T23:15:26Z","timestamp":1705619726000},"page":"e003837","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":27,"title":["Upadacitinib therapy in refractory inflammatory myositis: a case series of 10 patients"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3050-9292","authenticated-orcid":false,"given":"Madelaine","family":"Beckett","sequence":"first","affiliation":[{"name":"Internal Medicine, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Dutz","sequence":"additional","affiliation":[{"name":"Dermatology, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada"},{"name":"Vancouver General Hospital, Vancouver, British Columbia, Canada"},{"name":"Rheumatology, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0242-6959","authenticated-orcid":false,"given":"Kun","family":"Huang","sequence":"additional","affiliation":[{"name":"Vancouver General Hospital, Vancouver, British Columbia, Canada"},{"name":"Rheumatology, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada"},{"name":"Medicine, Surrey Memorial Hospital, Surrey, British Columbia, Canada"},{"name":"Arthritis Research Canada, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,1,18]]},"reference":[{"key":"2025090313593004000_10.1.e003837.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30254-0"},{"key":"2025090313593004000_10.1.e003837.2","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1002\/art.41602","article-title":"Study of tofacitinib in refractory dermatomyositis: an open-label pilot study of ten patients","volume":"73","author":"Paik","year":"2021","journal-title":"Arthritis Rheumatol"},{"key":"2025090313593004000_10.1.e003837.3","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.jaad.2021.07.003","article-title":"Tofacitinib as treatment for refractory dermatomyositis: a retrospective study from 2 academic medical centers","volume":"86","author":"Min","year":"2022","journal-title":"J Am Acad Dermatol"},{"key":"2025090313593004000_10.1.e003837.4","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1001\/jamadermatol.2016.0866","article-title":"Tofacitinib citrate for refractory cutaneous dermatomyositis: an alternative treatment","volume":"152","author":"Kurtzman","year":"2016","journal-title":"JAMA Dermatol"},{"key":"2025090313593004000_10.1.e003837.5","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1002\/art.41944","article-title":"Long-term extension study of tofacitinib in refractory dermatomyositis","volume":"74","author":"Paik","year":"2022","journal-title":"Arthritis Rheumatol"},{"key":"2025090313593004000_10.1.e003837.6","doi-asserted-by":"crossref","unstructured":"Beckett M , Tan J , Bonnardeaux E , et al . Tofacitinib therapy in refractory inflammatory myositis: a retrospective cohort study of 41 patients. Rheumatology (Oxford) 2023:kead404. doi:10.1093\/rheumatology\/kead404","DOI":"10.1093\/rheumatology\/kead404"},{"key":"2025090313593004000_10.1.e003837.7","doi-asserted-by":"crossref","first-page":"e387","DOI":"10.1093\/rheumatology\/keab421","article-title":"Calcinosis in refractory dermatomyositis improves with tofacitinib monotherapy: a case series","volume":"60","author":"Shneyderman","year":"2021","journal-title":"Rheumatology (Oxford)"},{"key":"2025090313593004000_10.1.e003837.8","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.jaut.2019.03.003","article-title":"Successful treatment of extensive calcifications and acute pulmonary involvement in dermatomyositis with the janus-kinase inhibitor tofacitinib - a report of two cases","volume":"100","author":"Wendel","year":"2019","journal-title":"J Autoimmun"},{"key":"2025090313593004000_10.1.e003837.9","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/key188"},{"key":"2025090313593004000_10.1.e003837.10","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1056\/NEJMc1900045","article-title":"Tofacitinib in amyopathic dermatomyositis-associated interstitial lung disease","volume":"381","author":"Chen","year":"2019","journal-title":"N Engl J Med"},{"key":"2025090313593004000_10.1.e003837.11","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1080\/14397595.2021.1906505","article-title":"Tofacitinib in interstitial lung disease complicated with anti-Mda5 antibody-positive dermatomyositis: a literature review","volume":"32","author":"Takanashi","year":"2022","journal-title":"Mod Rheumatol"},{"key":"2025090313593004000_10.1.e003837.12","first-page":"348","article-title":"Use of Janus kinase inhibitors in dermatomyositis: a systematic literature review","volume":"41","author":"Paik","year":"2023","journal-title":"Clin Exp Rheumatol"},{"key":"2025090313593004000_10.1.e003837.13","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2021-eular.722"},{"key":"2025090313593004000_10.1.e003837.14","doi-asserted-by":"publisher","DOI":"10.1002\/ana.20464"},{"key":"2025090313593004000_10.1.e003837.15","doi-asserted-by":"publisher","DOI":"10.1002\/art.22928"},{"key":"2025090313593004000_10.1.e003837.16","doi-asserted-by":"publisher","DOI":"10.2119\/2006-00085.Baechler"},{"key":"2025090313593004000_10.1.e003837.17","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0029161","article-title":"Interferon and biologic signatures in dermatomyositis skin: specificity and heterogeneity across diseases","volume":"7","author":"Wong","year":"2012","journal-title":"PLoS ONE"},{"key":"2025090313593004000_10.1.e003837.18","doi-asserted-by":"crossref","first-page":"e1193","DOI":"10.1212\/WNL.0000000000008128","article-title":"Identification of distinctive interferon gene signatures in different types of myositis","volume":"93","author":"Pinal-Fernandez","year":"2019","journal-title":"Neurology"},{"key":"2025090313593004000_10.1.e003837.19","doi-asserted-by":"crossref","unstructured":"McInnes IB , Byers NL , Higgs RE , et al . Comparison of baricitinib, upadacitinib, and tofacitinib mediated regulation of cytokine signaling in human leukocyte subpopulations. 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