Baricitinib as a treatment for myasthenia gravis: a case report

•Myasthenia gravis (MG) was treated with baricitinib, a JAK1/JAK2 inhibitor.•Baricitinib proved effective for MG and alopecia areata resistant to steroids.•JAK2 may play a pivotal role in mediating MG symptoms.•Hair regrowth was observed during baricitinib therapy.•This case highlights the potential...

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Bibliographic Details
Published in:Neuromuscular disorders : NMD 2024-08, Vol.41, p.56-58
Main Authors: Iguchi, Masahiro, Honjo, Jyunichiro, Yamamoto, Toshiyuki, Kanai, Kazuaki
Format: Article
Language:English
Subjects:
AChR antibody
Alopecia areata
JAK inhibitor
Myasthenia gravis
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Summary:•Myasthenia gravis (MG) was treated with baricitinib, a JAK1/JAK2 inhibitor.•Baricitinib proved effective for MG and alopecia areata resistant to steroids.•JAK2 may play a pivotal role in mediating MG symptoms.•Hair regrowth was observed during baricitinib therapy.•This case highlights the potential of JAK inhibitors in treating MG cases. Myasthenia gravis (MG) is an autoimmune disease that targets neuromuscular junctions. While immunotherapy remains the cornerstone of treatment, the effects of Janus kinase (JAK) inhibitors on MG remain underexplored. In this report, we describe the case of a 58-year-old woman with ocular myasthenia gravis who received treatment with the JAK inhibitor, baricitinib for alopecia areata. The patient presented with left eyelid ptosis and an inadequate response to steroids and pyridostigmine, along with symptoms of alopecia areata. Following diagnosis, we initiated a treatment regimen consisting of baricitinib for six months. After initiation of baricitinib, we observed a complete resolution of the patient's MG symptoms, accompanied by hair regrowth, even when steroids were tapered and pyridostigmine was discontinued. Furthermore, the titer of the anti-acetylcholine receptor antibody was decreased. This report represents the first reported case of anti-acetylcholine receptor antibody-positive MG that was successfully treated through the inhibition of JAK activity.
ISSN:0960-8966
1873-2364
1873-2364
DOI:10.1016/j.nmd.2024.06.006