Tofacitinib monotherapy as maintenance treatment in juvenile dermatomyositis: a case report

Juvenile dermatomyositis (JDM) is a multisystem autoimmune disease associated with considerable morbidity and mortality, having a significant impact on patient health. Early diagnosis and appropriate treatment play a key role in optimising outcomes. JDM management remains challenging, particularly in severe or refractory cases, due to the limited evidence regarding therapeutic options. Given these challenges, Janus kinase inhibitors, including tofacitinib, have emerged as promising alternatives, yet evidence in paediatric populations is still scarce. We present the case of a child with JDM who achieved sustained remission with tofacitinib monotherapy following the failure of previous therapies. While its use is currently restricted to refractory cases, these findings suggest its potential for earlier integration into treatment algorithms. This work aims to provide valuable insights to guide therapeutic strategies in JDM.