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Tofacitinib for the treatment of refractory immune checkpoint inhibitor-associated immune nephritis

Kiran Shivaraj1, Amanda Tchakarov2, Yanlan Dong1

  • 1Section of Nephrology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Clinical Kidney Journal
|May 28, 2024
PubMed

Immune checkpoint inhibitor (ICI)-associated immune nephritis or acute interstitial nephritis (AIN) is one of the rare but known complication of ICI therapy. Guidelines recommend treatment of ICI-associated AIN with steroids, then TNF-alpha inhibitor infliximab. However, some cases are refractory to these therapies, potentially due to insufficient cytokine blockade. This is the first case where a 65-year-old female with metastatic lung adenocarcinoma, requiring high maintenance doses of steroids for immune nephritis was treated with tofacitinib, an oral Janus kinase (JAK) inhibitor. Tofacitinib enabled successful steroid tapering and might be a therapy option for refractory immune nephritis.

Keywords:
acute interstitial nephritisimmune checkpoint inhibitorsimmune nephritisimmune-related adverse eventstofacitinib

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