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Tofacitinib Use in a Patient With Rheumatoid Arthritis and Polycythemia Vera: A Case Report.
Milan Bogojevic1, Rifat Medjedovic1, Milica Markovic1
1Clinical Center of Montenegro Department of Rheumatology Podgorica Montenegro.
Clinical Case Reports
|January 5, 2026
Summary
Tofacitinib effectively treated rheumatoid arthritis (RA) in a patient with polycythemia vera (PV). The JAK inhibitor showed rheumatologic benefits with minimal impact on PV hematologic activity.
Area of Science:
- Rheumatology
- Hematology
- Oncology
Background:
- Rheumatoid arthritis (RA) involves joint inflammation, while polycythemia vera (PV) is a JAK2-mutated myeloproliferative neoplasm causing erythrocytosis.
- JAK inhibitors are used in RA, but typically spare JAK2, crucial for PV.
Purpose of the Study:
- To evaluate the efficacy and safety of tofacitinib in a patient with coexisting RA and PV.
Main Methods:
- A 61-year-old female patient with seropositive RA and JAK2 V617F-positive PV was treated with hydroxyurea for PV.
- RA treatment with methotrexate and sulfasalazine was switched to tofacitinib 5 mg twice daily due to intolerance.
Main Results:
- Tofacitinib induced clinical and ultrasonographic remission of RA within 3 months, with improved inflammatory markers.
- Hematologic parameters remained stable; hydroxyurea dose was reduced after 6 months, but tapering led to erythrocytosis recurrence.
- RA remission persisted for 12 months without adverse events or cytopenias, indicating tofacitinib's rheumatologic efficacy but minimal effect on PV hematologic activity.
Conclusions:
- Tofacitinib is a viable treatment option for RA in patients with PV, demonstrating significant rheumatologic efficacy.
- The JAK inhibitor showed limited impact on the hematologic aspects of PV, suggesting careful monitoring and management of both conditions are necessary.
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