Dropouts
headaches, inflammation, retinal central venous occlusion, infections, pulmonary embolus, polymyalgia rheumatica, gout, shortness of breath
INFLAMMATION, MINOR, INFECTIONS, GCA, POLYMYALGIA RHEUMATICA, PULMONARY EMBOLUS, CHRONIC HEADACHES, GOUT
Aside from the 15 patients described above, three individuals were excluded from the case series as they did not prevail on JAKi for 6 months or had poor adherence to therapy.One 85-year-old man was diagnosed with polymyalgia rheumatica in 2016. Two years later, a diagnosis of GCA was settled based on positive US findings. He also suffered from gout, recurrent infections, and chronic headaches. After 2 years, baricitinib was started in an attempt to treat headaches and systemic inflammation (increasing CRP levels). In a follow-up 2.5 months later, he had ceased baricitinib and did not notice any difference. At re-evaluation, GCA activity at the initiation of baricitinib was considered unlikely. Due to this, in combination with poor adherence to therapy, this patient was excluded from the study.Another man was diagnosed with GCA in 2013 at the age of 74 years. Seven years later, relapse was suspected based on disturbed vision combined with a minor CRP elevation (7.5 mg/L). However, after re-evaluation 4 months later, retinal central venous occlusion per se without GCA activity was considered to explain his symptoms. Baricitinib was used for 4 months, but the patient was not included herein since attribution to GCA could not be confirmed.Finally, a 77-year-old man with several comorbidities was diagnosed with GCA based on positive US findings and positive TAB in 2021. After 1 year on corticosteroids, baricitinib was added in order to reduce the prednisolone doses. Two months later, the patient developed shortness of breath, and a minor pulmonary embolus was observed on CT. He was treated with anticoagulation, baricitinib was ceased, and TCZ was initiated.