ArticleRMD open2023
Efficacy and safety of dose escalation of tofacitinib in refractory anti-MDA5 antibody-positive dermatomyositis.
Article in RMD open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
36 citing papers in PubMed, 2 syntheses or guidelines pooled it, 51 citations in OpenAlex.
- Pooled it
- The efficacy and safety of tofacitinib in anti-melanoma differentiation-associated gene 5 antibody positive dermatomyositis associated interstitial lung disease: a systematic review and meta-analysis.Therapeutic advances in respiratory diseasePooled it
- PCR-confirmed severe geographic HSV-1 keratitis associated with systemic JAK inhibitor therapy.Journal of ophthalmic inflammation and infection · 2026Article
- Article
- Advances in Biomarkers and Therapeutic Targets for Idiopathic Inflammatory Myopathies Related Lung Disease.Clinical reviews in allergy & immunology · 2026Review
- Dermatomyositis with Anti-MDA5 Autoantibodies After SARS-CoV-2 mRNA Vaccination Treated with Tofacitinib: Integrating Literature Evidence and a Novel Observation.Antibodies (Basel, Switzerland) · 2026Review
- Article
- Cytomegalovirus DNAemia in patients with anti-melanoma differentiation-associated gene 5 positive dermatomyositis from southern China.BMC infectious diseases · 2026Article
- Janus kinase and calcineurin-inhibitor combination in anti-MDA5 dermatomyositis: No significant survival benefit but reassuring safety profile.Journal of internal medicine · 2026Article
- Case Report: Glucocorticoids with Early Aggressive Rituximab and Upadacitinib regimen in the treatment of three patients with anti-MDA5 dermatomyositis-associated interstitial lung disease.Frontiers in medicine · 2026Article
- Dose-Escalated Upadacitinib for Refractory Myositis in Anti-Jo-1-Positive Antisynthetase Syndrome: A Case Report.Case reports in rheumatology · 2026Article
- Case Report: Lung transplantation for rare anti-MDA5-positive rapidly progressive interstitial lung disease: two cases and a narrative review.Frontiers in immunology · 2026Review
- Targeted therapy against recurrent anti-synthetase syndrome associated interstitial lung disease after bilateral lung transplantation guided by transcriptomic analyses: a case-based study.Frontiers in immunology · 2026Article
- Baricitinib could improve the prognosis of anti-MDA5 antibody positive dermatomyositis associated interstitial lung disease.Arthritis research & therapy · 2025Article
- How to treat patients with MDA5-associated rapidly progressive interstitial lung disease? Which immunosuppressive therapy for which patients?The European respiratory journal · 2025Article
- Treating connective tissue disease-associated interstitial lung disease - think outside the box: a perspective.European respiratory review : an official journal of the European Respiratory Society · 2025Review
- Predictive Biomarkers and Novel Treatments for the Progressive Fibrosing Phenotype in Interstitial Lung Disease Associated with Connective Tissue Disease.Biomedicines · 2025Review
- Severe infection risk in triple and quadruple therapy for anti-MDA5 antibody-positive dermatomyositis.Clinical rheumatology · 2025Article
- Anti- Melanoma Differentiation-Associated Gene 5 Antibody Positive Dermatomyositis: Recent Progress in Pathophysiology and Treatment.Current rheumatology reports · 2025Review
- Effectiveness and safety of tofacitinibThe European respiratory journal · 2025Article
Corrections and comments
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Authors and funding
12 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Anti-melanoma differentiation-associated protein 5 (MDA5) antibody-positive dermatomyositis (MDA5-DM) is frequently complicated with rapidly progressive-interstitial lung disease (RP-ILD). The prognosis of MDA5-DM with RP-ILD is mostly poor despite intensive treatment with a combination of high-dose glucocorticoids and single conventional immunosuppressants. It was reported that the triple therapy (high-dose glucocorticoids, cyclophosphamide and tacrolimus) was more effective than a combination of high-dose glucocorticoids and stepwise addition of immunosuppressants. In addition, the efficacy of tofacitinib 10 mg/day for MDA5-DM with RP-ILD refractory to the triple therapy was suggested. However, the effect of those therapies was evaluated only in comparison to the historical control. Moreover, more importantly, there are still refractory patients even if treated with those therapies. In this case series, we report six MDA5-DM cases with RP-ILD in which the dose of tofacitinib was increased from 10 mg to 20 mg/day due to poor response to the triple therapy, followed by tofacitinib 10 mg/day. Four of six patients improved after dose escalation of tofacitinib, while two non-responders died. All six patients developed at least one infection including five cases of cytomegalovirus reactivation, one pulmonary aspergillosis, one herpes zoster and one herpes simplex keratitis. These cases suggest that the dose escalation of tofacitinib can be an option for MDA5-DM patients refractory to 10 mg/day of tofacitinib and other immunosuppressants although the risk of infection is a concern. The risk-benefit balance of the dose escalation of tofacitinib should be carefully assessed in each case.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.