Tofacitinib effectiveness in Blau syndrome: a case series of Chinese paediatric patients

Pediatr Rheumatol Online J. 2021 Nov 15;19(1):160. doi: 10.1186/s12969-021-00634-x.

Abstract

Objective: Blau syndrome (BS), a rare, autosomal-dominant autoinflammatory syndrome, is characterized by a clinical triad of granulomatous recurrent uveitis, dermatitis, and symmetric arthritis and associated with mutations of the nucleotide-binding oligomerization domain containing 2 (NOD2) gene. Aim of this study was to assess the efficacy of tofacitinib in Chinese paediatric patients with BS.

Methods: Tofacitinib was regularly administered to three BS patients (Patient 1, Patient 2, and Patient 3) at different dosages: 1.7 mg/day (0.11 mg/kg), 2.5 mg/day (0.12 mg/kg), and 2.5 mg/day (0.33 mg/kg). The clinical manifestations of the patients, magnetic resonance imaging results, serological diagnoses, therapeutic measures and outcomes of treatments are described in this report.

Results: The clinical characteristics and serological diagnoses of all BS patients were greatly improved after the administration of tofacitinib treatment. All patients reached clinical remission of polyarthritis and improvements in the erythrocyte sedimentation rate (ESR) and levels of C-reactive protein (CRP) and inflammatory cytokines.

Conclusion: Tofacitinib, a Janus kinase (JAK) inhibitor, is a promising agent for BS patients who have unsatisfactory responses to corticosteroids, traditional disease-modifying antirheumatic drugs, and biological agents.

Keywords: Arthritis; Blau syndrome; JAK inhibitors; NOD2; Tofacitinib.

Publication types

  • Case Reports

MeSH terms

  • Arthritis / blood
  • Arthritis / diagnosis
  • Arthritis / drug therapy*
  • Biomarkers / blood
  • Blood Sedimentation
  • C-Reactive Protein / metabolism
  • Child
  • Child, Preschool
  • Cytokines / blood
  • Electrocardiography
  • Follow-Up Studies
  • Humans
  • Infant
  • Janus Kinase Inhibitors / therapeutic use
  • Joints / pathology
  • Magnetic Resonance Imaging / methods
  • Male
  • Piperidines / therapeutic use*
  • Pyrimidines / therapeutic use*
  • Sarcoidosis / blood
  • Sarcoidosis / diagnosis
  • Sarcoidosis / drug therapy*
  • Synovitis / blood
  • Synovitis / diagnosis
  • Synovitis / drug therapy*
  • Time Factors
  • Uveitis / blood
  • Uveitis / diagnosis
  • Uveitis / drug therapy*

Substances

  • Biomarkers
  • Cytokines
  • Janus Kinase Inhibitors
  • Piperidines
  • Pyrimidines
  • tofacitinib
  • C-Reactive Protein

Supplementary concepts

  • Blau syndrome