{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T01:18:46Z","timestamp":1792718326425,"version":"4.5.0"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T00:00:00Z","timestamp":1684972800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007949","name":"Reumatikerf\u00f6rbundet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007949","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016670","name":"Region \u00d6sterg\u00f6tland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016670","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007857","name":"Stiftelsen Konung Gustaf V:s 80-\u00e5rsfond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007857","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006129","name":"Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006129","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>The Janus kinase (JAK)\u2013STAT signaling pathway is relevant in both Takayasu and giant cell arteritis (GCA), and the use of JAK inhibitors (JAKi) in arthritis, psoriasis, and inflammatory bowel disease is nowadays common. Some evidence of the clinical efficacy of JAKi in GCA exists and a phase III randomized controlled trial (RCT) of upadacitinib is currently recruiting. In 2017, we started using barcitinib in a GCA patient with inadequate response to corticosteroids, and later on, we treated other 14 GCA patients with baricitinib\/tofacitinib during intense follow-up. The retrospective data of these 15 individuals are here summarized. GCA was diagnosed based on the ACR criteria and\/or imaging techniques combined with increased C-reactive protein (CRP) and\/or erythrocyte sedimentation rate (ESR) followed by a good initial response to corticosteroids. JAKi was initiated based on inflammatory activity, with increased CRP, presumably dependent on GCA with clinical symptoms, despite unsatisfying high doses of prednisolone. The mean age at JAKi initiation was 70.1 years and the mean exposure to JAKi was 19 months. From initiation, significant reductions in CRP were seen already at 3 (<jats:italic>p<\/jats:italic> = 0.02) and 6 (<jats:italic>p<\/jats:italic> = 0.02) months. A slower decrease was observed regarding ESR at 3 (<jats:italic>p<\/jats:italic> = 0.12) and 6 (<jats:italic>p<\/jats:italic> = 0.02) months. Furthermore, the daily prednisolone doses were reduced at 3 (<jats:italic>p<\/jats:italic> = 0.02) and 6 (<jats:italic>p<\/jats:italic> = 0.004) months. No GCA relapses were observed. Two patients were affected by serious infections, but JAKi therapy was retained or reintroduced after recovery. We present encouraging observational data on JAKi in GCA in one of the hitherto largest case series with long-term follow-up. Our clinical experiences will complement the results from the awaited RCT.<\/jats:p>","DOI":"10.3389\/fimmu.2023.1187584","type":"journal-article","created":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T04:11:33Z","timestamp":1684987893000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":18,"title":["Clinical experience and safety of Janus kinase inhibitors in giant cell arteritis: a retrospective case series from Sweden"],"prefix":"10.3389","volume":"14","author":[{"given":"Per","family":"Eriksson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Skoglund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Hemgren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Sj\u00f6wall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,5,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/art.37715","article-title":"2012 revised international chapel hill consensus conference nomenclature of vasculitides","volume":"65","author":"Jennette","year":"2013","journal-title":"Arthritis Rheum"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.807996","article-title":"The diagnostic performance of an extended ultrasound protocol in patients with clinically suspected giant cell arteritis","volume":"8","author":"Skoog","year":"2021","journal-title":"Front Med (Lausanne)"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780330810","article-title":"The American college of rheumatology 1990 criteria for the classification of giant cell arteritis","volume":"33","author":"Hunder","year":"1990","journal-title":"Arthritis Rheum"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.1082604","article-title":"Norwegian Society of rheumatology recommendations on diagnosis and treatment of patients with giant cell arteritis","volume":"9","author":"Haaversen","year":"2022","journal-title":"Front Med (Lausanne)"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.117.030423","article-title":"Inhibition of JAK-STAT signaling suppresses pathogenic immune responses in medium and Large vessel vasculitis","volume":"137","author":"Zhang","year":"2018","journal-title":"Circulation"},{"key":"B6","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1038\/s41572-021-00327-5","article-title":"Large-Vessel vasculitis","volume":"7","author":"Pugh","year":"2022","journal-title":"Nat Rev Dis Primers."},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1613849","article-title":"Trial of tocilizumab in giant-cell arteritis","volume":"377","author":"Stone","year":"2017","journal-title":"N Engl J Med"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcb.2010.10.007","article-title":"The soluble interleukin 6 receptor: generation and role in inflammation and cancer","volume":"90","author":"Chalaris","year":"2011","journal-title":"Eur J Cell Biol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2004.02.003","article-title":"Reduced anti-TNFalpha autoantibody levels coincide with flare in systemic lupus erythematosus","volume":"22","author":"Sj\u00f6wall","year":"2004","journal-title":"J Autoimmun"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1002\/art.39740","article-title":"Brief report: a prospective open-label phase IIa trial of tocilizumab in the treatment of polymyalgia rheumatica","volume":"68","author":"Lally","year":"2016","journal-title":"Arthritis Rheumatol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.cyto.2021.155690","article-title":"Blocking only the bad side of IL-6 in inflammation and cancer","volume":"148","author":"Rose-John","year":"2021","journal-title":"Cytokine"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.109.872903","article-title":"Th17 and Th1 T-cell responses in giant cell arteritis","volume":"121","author":"Deng","year":"2010","journal-title":"Circulation"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2019-216900","article-title":"Targeting JAK\/STAT pathway in takayasu's arteritis","volume":"79","author":"R\u00e9gnier","year":"2020","journal-title":"Ann Rheum Dis"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.881705","article-title":"Perspectives of jak inhibitors for Large vessel vasculitis","volume":"13","author":"Watanabe","year":"2022","journal-title":"Front Immunol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keaa281","article-title":"Tofacitinib in patients with refractory takayasu's arteritis","volume":"59","author":"Li","year":"2020","journal-title":"Rheumatol (Oxford)"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2021-220832","article-title":"Treatment efficacy and safety of tofacitinib versus methotrexate in takayasu arteritis: a prospective observational study","volume":"81","author":"Kong","year":"2022","journal-title":"Ann Rheum Dis"},{"key":"B17","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1007\/s10067-021-05973-4","article-title":"A systematic review of clinical and preclinical evidences for janus kinase inhibitors in large vessel vasculitis","volume":"41","author":"Rathore","year":"2022","journal-title":"Clin Rheumatol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2020.10.022","article-title":"The emerging role of janus kinase inhibitors in the treatment of autoimmune and inflammatory diseases","volume":"147","author":"Damsky","year":"2021","journal-title":"J Allergy Clin Immunol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2021-221961","article-title":"Baricitinib for relapsing giant cell arteritis: a prospective open-label 52-week pilot study","volume":"81","author":"Koster","year":"2022","journal-title":"Ann Rheum Dis"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2021-eular.3435","article-title":"Ab0379 baricitinib in polymyalgia rheumatica and giant cell arteritis: report of six cases","volume":"80","author":"Camellino","year":"2021","journal-title":"Ann Rheumatic Dis"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keab541","article-title":"Efficacy of baricitinib for refractory large-vessel vasculitis","volume":"60","author":"R\u00e9gent","year":"2021","journal-title":"Rheumatol (Oxford)"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1097\/rlu.0000000000003913","article-title":"JAK inhibitor effectiveness in giant-cell arteritis with Large-vessel involvement assessed by 18F-FDG PET-CT","volume":"47","author":"Prigent","year":"2022","journal-title":"Clin Nucl Med"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keac203","article-title":"Therapeutic effectiveness of upadacitinib combined with glucocorticoid on remission induction and maintenance in giant cell arteritis","volume":"61","author":"Sanada","year":"2022","journal-title":"Rheumatol (Oxford)"},{"key":"B24","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1111\/bjh.15854","article-title":"Successful treatment of chronic neutrophilic leukaemia and associated giant cell arteritis with the combination of ruxolitinib and azacytidine","volume":"185","author":"Herlihy","year":"2019","journal-title":"Supplement Article Br J Haematol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1111\/cpf.12601","article-title":"Vascular ultrasound for monitoring of inflammatory activity in takayasu arteritis","volume":"40","author":"Svensson","year":"2020","journal-title":"Clin Physiol Funct Imaging"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.15361","article-title":"Thromboembolic events in janus kinase inhibitors: a pharmacovigilance study from 2012 to 2021 based on the food and drug administration's adverse event reporting system","volume":"88","author":"Dong","year":"2022","journal-title":"Br J Clin Pharmacol"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2022-223050","article-title":"Venous thromboembolism with JAK inhibitors and other immune-modulatory drugs: a Swedish comparative safety study among patients with rheumatoid arthritis","volume":"82","author":"Molander","year":"2023","journal-title":"Ann Rheum Dis"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1507247","article-title":"Baricitinib in patients with refractory rheumatoid arthritis","volume":"374","author":"Genovese","year":"2016","journal-title":"N Engl J Med"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1002\/art.39953","article-title":"Baricitinib, methotrexate, or combination in patients with rheumatoid arthritis and no or limited prior disease-modifying antirheumatic drug treatment","volume":"69","author":"Fleischmann","year":"2017","journal-title":"Arthritis Rheumatol"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2023.1187584\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T04:11:36Z","timestamp":1684987896000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2023.1187584\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,25]]},"references-count":29,"alternative-id":["10.3389\/fimmu.2023.1187584"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2023.1187584","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,25]]},"article-number":"1187584"}}