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Successful remission with tofacitinib in a patient with refractory Takayasu arteritis complicated by ulcerative colitis
  1. Saki Kuwabara1,
  2. Shun Tanimura1,
  3. Shogo Matsumoto2,
  4. Hiroyuki Nakamura1,
  5. Tetsuya Horita1
  1. 1 Internal Medicine, Tomakomai City Hospital, Tomakomai, Japan
  2. 2 Gastroenterology, Tomakomai City Hospital, Tomakomai, Japan
  1. Correspondence to Dr Tetsuya Horita, Internal Medicine, Tomakomai City Hospital, Tomakomai 053-8567, Japan; thorita{at}med.hokudai.ac.jp

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Takayasu arteritis (TAK) is a form of large vessel vasculitis resulting in thickening and stenosis of the large-sized arteries, particularly the aorta and its main branches. Ulcerative colitis (UC) is a major complication of TAK, sharing some genetic background and pathogenesis.1 Serum levels of pro-inflammatory cytokines, such as interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α), are potential biomarkers to reflect disease activity of TAK. Thus, IL-6 or TNF-α inhibitors have been used for treating refractory TAK. A randomised controlled trial suggested clinical efficacy and safety of tocilizumab in patients with refractory TAK, although the trial failed to achieve its primary endpoint.2 We here present a patient in whom tofacitinib (TOF), a Janus kinase (JAK) inhibitor, successfully induced a remission of TAK and UC resistant to both TNF-α and IL-6 inhibitors.

A 32-year-old Japanese female with a medical history of TAK and UC visited our hospital complaining of chest pain, abdominal …

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Footnotes

  • Handling editor Josef S Smolen

  • Contributors SK provided the figure and wrote the manuscript. ST participated in follow-up, edited the manuscript. SM collected the clinical data of colonoscopy. HN and TH contributed to the discussion and edited the manuscript. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.