Suzuki Koji, Akiyama Mitsuhiro, Inokuchi Hajime, Saito Koichi, Hanaoka Hironari, Kaneko Yuko
Department of Internal Medicine, Division of Rheumatology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
Rheumatol Int. 2024 Dec;44(12):3127-3133. doi: 10.1007/s00296-024-05735-w. Epub 2024 Oct 9.
Inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease (CD), not only causes significant intestinal inflammation but also leads to extra-intestinal manifestations such as spondyloarthritis (SpA). Although the efficacy of tumor necrosis factor (TNF) inhibitors has been reported for IBD-related SpA, some cases still encounter treatment failure, highlighting the need for novel therapeutic alternatives. Recently, Janus kinase inhibitors have demonstrated their efficacy in IBD and SpA, yet their impact on CD-related SpA remains unexplored. Here we present the first two cases of CD-related peripheral SpA successfully treated with upadacitinib. Additionally, our literature review identified a reported case of CD-related peripheral SpA treated with tofacitinib. All cases achieved clinical remission of both CD and peripheral SpA with Janus kinase inhibitors, and no adverse events or disease relapses were reported during the observation period. Our cases and literature review highlight the promising potential of Janus kinase inhibitors as a novel treatment not only for intestinal inflammation of CD, but also for CD-related peripheral SpA.
炎症性肠病（IBD），包括溃疡性结肠炎和克罗恩病（CD），不仅会引发严重的肠道炎症，还会导致诸如脊柱关节炎（SpA）等肠外表现。尽管已有报道称肿瘤坏死因子（TNF）抑制剂对IBD相关的SpA有效，但仍有一些病例治疗失败，这凸显了需要新的治疗选择。最近，Janus激酶抑制剂已在IBD和SpA中显示出疗效，但其对CD相关SpA的影响仍未得到探索。在此，我们报告了首例使用乌帕替尼成功治疗的两例CD相关外周SpA病例。此外，我们的文献综述发现了一例使用托法替布治疗的CD相关外周SpA报告病例。所有病例使用Janus激酶抑制剂后均实现了CD和外周SpA的临床缓解，且在观察期内未报告不良事件或疾病复发。我们的病例和文献综述凸显了Janus激酶抑制剂作为一种不仅对CD肠道炎症，而且对CD相关外周SpA的新型治疗方法的潜在前景。
