Tofacitinib as an adjuvant treatment for pediatric Still's disease

ObjectiveTo describe the efficacy and safety of tofacitinib for pediatric Still's disease, also referred to as systemic-onset juvenile idiopathic arthritis (sJIA). Traditional non-biological drugs and drugs targeting the interleukin-1 and interleukin-6 pathways benefit some patients, but others...

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Main Authors: Ling Hou, Peng Zhou, Chengguang Zhao, Xiuli Wang, Yue Du
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1650675/full
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author Ling Hou
Peng Zhou
Chengguang Zhao
Xiuli Wang
Yue Du
author_facet Ling Hou
Peng Zhou
Chengguang Zhao
Xiuli Wang
Yue Du
author_sort Ling Hou
collection DOAJ
description ObjectiveTo describe the efficacy and safety of tofacitinib for pediatric Still's disease, also referred to as systemic-onset juvenile idiopathic arthritis (sJIA). Traditional non-biological drugs and drugs targeting the interleukin-1 and interleukin-6 pathways benefit some patients, but others show inadequate responses.MethodsWe retrospectively analyzed ten patients with pediatric Still's disease who were treated with tofacitinib and had at least one follow-up visit. Data on patient history, laboratory findings, and treatments were collected at disease onset, at the initiation of tofacitinib, and during follow-up.ResultsTofacitinib led to complete remission in six patients, partial remission in three patients, and loss of efficacy in one patient. Among the nine patients with remission, two discontinued corticosteroids entirely and seven used lower dosages of corticosteroids; these patients also used fewer concurrent medications (1 or 2) after tofacitinib initiation. The one patient who experienced loss of efficacy continued to require a higher dosage of corticosteroids and received five different additional medications. The other nine patients received tocilizumab and had a decreased frequency of these injections after tofacitinib initiation. Tofacitinib was well-tolerated, with only one reported instance of an upper respiratory tract infection.ConclusionsTofacitinib appears to be an effective adjunct therapy for management of pediatric Still's disease, particularly for patients with unstable clinical conditions and adverse reactions to corticosteroids.
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spelling doaj-art-94ec2a754df644ab826223d7cab46ac32025-08-20T05:32:51ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-08-011310.3389/fped.2025.16506751650675Tofacitinib as an adjuvant treatment for pediatric Still's diseaseLing HouPeng ZhouChengguang ZhaoXiuli WangYue DuObjectiveTo describe the efficacy and safety of tofacitinib for pediatric Still's disease, also referred to as systemic-onset juvenile idiopathic arthritis (sJIA). Traditional non-biological drugs and drugs targeting the interleukin-1 and interleukin-6 pathways benefit some patients, but others show inadequate responses.MethodsWe retrospectively analyzed ten patients with pediatric Still's disease who were treated with tofacitinib and had at least one follow-up visit. Data on patient history, laboratory findings, and treatments were collected at disease onset, at the initiation of tofacitinib, and during follow-up.ResultsTofacitinib led to complete remission in six patients, partial remission in three patients, and loss of efficacy in one patient. Among the nine patients with remission, two discontinued corticosteroids entirely and seven used lower dosages of corticosteroids; these patients also used fewer concurrent medications (1 or 2) after tofacitinib initiation. The one patient who experienced loss of efficacy continued to require a higher dosage of corticosteroids and received five different additional medications. The other nine patients received tocilizumab and had a decreased frequency of these injections after tofacitinib initiation. Tofacitinib was well-tolerated, with only one reported instance of an upper respiratory tract infection.ConclusionsTofacitinib appears to be an effective adjunct therapy for management of pediatric Still's disease, particularly for patients with unstable clinical conditions and adverse reactions to corticosteroids.https://www.frontiersin.org/articles/10.3389/fped.2025.1650675/fullJAK-STATjanus kinase inhibitorpediatric Still’s diseasesystemic juvenile idiopathic arthritistofacitinib
spellingShingle Ling Hou
Peng Zhou
Chengguang Zhao
Xiuli Wang
Yue Du
Tofacitinib as an adjuvant treatment for pediatric Still's disease
Frontiers in Pediatrics
JAK-STAT
janus kinase inhibitor
pediatric Still’s disease
systemic juvenile idiopathic arthritis
tofacitinib
title Tofacitinib as an adjuvant treatment for pediatric Still's disease
title_full Tofacitinib as an adjuvant treatment for pediatric Still's disease
title_fullStr Tofacitinib as an adjuvant treatment for pediatric Still's disease
title_full_unstemmed Tofacitinib as an adjuvant treatment for pediatric Still's disease
title_short Tofacitinib as an adjuvant treatment for pediatric Still's disease
title_sort tofacitinib as an adjuvant treatment for pediatric still s disease
topic JAK-STAT
janus kinase inhibitor
pediatric Still’s disease
systemic juvenile idiopathic arthritis
tofacitinib
url https://www.frontiersin.org/articles/10.3389/fped.2025.1650675/full
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AT xiuliwang tofacitinibasanadjuvanttreatmentforpediatricstillsdisease
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