ArticleCase reports in rheumatology2026
Dose-Escalated Upadacitinib for Refractory Myositis in Anti-Jo-1-Positive Antisynthetase Syndrome: A Case Report.
Article in Case reports in rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Anti-Jo-1-positive antisynthetase syndrome (ASS) can follow a relapsing course during glucocorticoid tapering, and evidence for refractory myositis remains limited. We report a 33-year-old woman with anti-Jo-1-positive ASS with a dermatomyositis phenotype and recurrent myositis despite multiple immunosuppressants, biologics, and Janus kinase (JAK) inhibitors. Upadacitinib was increased from 15 to 30 mg/day during a flare, together with intravenous immunoglobulin and temporary prednisolone escalation. During follow-up, upadacitinib was withdrawn twice for fertility treatment; both withdrawals were followed by disease flares, and disease control was restored after reintroduction. Prednisolone was ultimately discontinued. This repeated withdrawal-rechallenge pattern suggests that dose-escalated upadacitinib may have contributed to sustained disease control.
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