Tofacitinib for the Treatment of Refractory Immune Checkpoint Inhibitor-Associated Immune Nephritis

Authors

Kiran Shivaraj
Amanda Tchakarov
Yanlan Dong
Jamie S Lin

Publication Date

5-1-2024

Journal

Clinical Kidney Journal

Abstract

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 nephritis, immune checkpoint inhibitors, immune nephritis, immune-related adverse events, tofacitinib

Comments

PMID: 38803394