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JAK Inhibitor Effectiveness in Giant-Cell Arteritis With Large-Vessel Involvement Assessed by 18F-FDG PET-CT
Kevin Prigent1, Achille Aouba2, Nicolas Aide1
1From the Departments of Nuclear Medicine.
Insights
A 76-year-old woman with relapsing giant-cell arteritis and large-vessel vasculitis showed improvement with baricitinib, a JAK inhibitor, after other treatments failed. 18F-FDG-PET/CT imaging helped monitor treatment response.
Area of Science:
- Immunology
- Radiology
- Rheumatology
Background:
- Giant-cell arteritis (GCA) is a chronic inflammatory condition affecting large arteries.
- Large-vessel vasculitis (LVV) can be a manifestation of GCA, posing significant clinical challenges.
- Treatment resistance is common in relapsing forms of GCA and LVV.
Observation:
- A 76-year-old female patient presented with relapsing GCA and LVV.
- Conventional therapies including methotrexate and tocilizumab were ineffective in achieving remission.
- 18F-FDG-PET/CT imaging was utilized to assess disease activity and treatment response.
Findings:
- The patient demonstrated a favorable clinical and radiological response to baricitinib, a Janus kinase (JAK) inhibitor.
- Baricitinib provided an effective therapeutic option when standard treatments failed.
- 18F-FDG-PET/CT imaging correlated with clinical improvement, indicating its utility in monitoring treatment efficacy.
Implications:
- Baricitinib may represent a novel and effective therapeutic strategy for GCA-related LVV.
- The use of 18F-FDG-PET/CT is validated as a tool for monitoring treatment response in these patients.
- This case highlights the potential of targeted therapies in managing refractory large-vessel vasculitis.
Abstract:
We report the case of a 76-year-old woman with relapsing giant-cell arteritis and large-vessel vasculitis demonstrated on 18F-FDG-PET/CT. Methotrexate and tocilizumab failed to achieve remission, and the patient ultimately exhibited a favorable clinical and radiological response to baricitinib, a JAK inhibitor. This case suggests that baricitinib may be a promising treatment for giant-cell arteritis-related large-vessel vasculitis and that 18F-FDG-PET/CT may be used to monitor therapeutic response.
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