Abstract
OBJECTIVE: To present a case series of eight patients with noninfectious chronic uveitis treated at a single institution with one of two JAK inhibitors (Jakinibs), upadacitinib or tofacitinib. SUBJECTS/METHODS: A retrospective chart review of patients seen by the uveitis service from 2015 to 2022 treated with upadacitinib and/or tofacitinib was performed. All patients included had previously failed alternative immunomodulatory therapy (IMT), had consistent ophthalmic evaluations for at least 6 months, and stayed on the Jakinib for at least 3 months. Eight patients were included. Demographic information was collected. Flares were classified clinically through visual acuity, symptoms, examination, and imaging. Side effects of the Jakinibs were recorded. RESULTS: The median length of Jakinib therapy duration was 29.5 months (range 6 months-43 months). Five patients were initiated on a Jakinib due to poor control of their ocular inflammatory diseases. Four of these patients achieved control with tofacitinib with or without additional steroid use; one patient achieved control with upadacitinib with one mild flare that resolved with systemic steroid use. Three patients started a Jakinib due to poor systemic disease control. Two of those remained flare-free of uveitis in the following year. The third patient had a flare that resolved with topical and oral therapy. Gastrointestinal upset was the most common side effect of tofacitinib. Upadacitinib had no reported side effects. CONCLUSION: Jakinibs may have a role in treatment of refractory noninfectious uveitis after failing conventional IMT. Both Jakinibs were well tolerated with a low incidence of side effects.