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oai:repisalud.isciii.es:20.500.12105/234552024-10-04T13:22:57Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16958col_20.500.12105_16967col_20.500.12105_16987

00925njm 22002777a 4500 dc Deyà-Martínez, Angela author Rivière, Jaques G author Roxo-Junior, Pérsio author Ramakers, Jan author Bloomfield, Markéta author Guisado Hernandez, Paloma author Blanco Lobo, Pilar author Abu Jamra, Soraya Regina author Esteve-Sole, Ana author Kanderova, Veronika author García-García, Ana author Lopez-Corbeto, Mireia author Martinez Pomar, Natalia author Martín-Nalda, Andrea author Alsina, Laia author Neth, Olaf author Olbrich, Peter author 2022-07 Introduction: Since the first description of gain of function (GOF) mutations in signal transducer and activator of transcription (STAT) 1, more than 300 patients have been described with a broad clinical phenotype including infections and severe immune dysregulation. Whilst Jak inhibitors (JAKinibs) have demonstrated benefits in several reported cases, their indications, dosing, and monitoring remain to be established. Methods: A retrospective, multicenter study recruiting pediatric patients with STAT1 GOF under JAKinib treatment was performed and, when applicable, compared with the available reports from the literature. Results: Ten children (median age 8.5 years (3-18), receiving JAKinibs (ruxolitinib (n = 9) and baricitinib (n = 1)) with a median follow-up of 18 months (2-42) from 6 inborn errors of immunity (IEI) reference centers were included. Clinical profile and JAKinib indications in our series were similar to the previously published 14 pediatric patients. 9/10 (our cohort) and 14/14 patients (previous reports) showed partial or complete responses. The median immune deficiency and dysregulation activity scores were 15.99 (5.2-40) pre and 7.55 (3-14.1) under therapy (p = 0.0078). Infection, considered a likely adverse event of JAKinib therapy, was observed in 1/10 patients; JAKinibs were stopped in 3/10 children, due to hepatotoxicity, pre-HSCT, and absence of response. Conclusions: Our study supports the potentially beneficial use of JAKinibs in patients with STAT1 GOF, in line with previously published data. However, consensus regarding their indications and timing, dosing, treatment duration, and monitoring, as well as defining biomarkers to monitor clinical and immunological responses, remains to be determined, in form of international prospective multicenter studies using established IEI registries. Deyà-Martínez A, Rivière JG, Roxo-Junior P, Ramakers J, Bloomfield M, Guisado Hernandez P, et al. Impact of JAK Inhibitors in Pediatric Patients with STAT1 Gain of Function (GOF) Mutations-10 Children and Review of the Literature. J Clin Immunol. 29 abril 2022. 10.1007/s10875-022-01257-x 1573-2592 Journal of clinical immunology http://hdl.handle.net/20.500.13003/18057 35486339 L2016132626 2-s2.0-85129184839 https://hdl.handle.net/20.500.12105/23455 788997500001 Baricitinib Chronic mucocutaneous candidiasis Inborn errors of immunity JAK inhibitors JAK-STAT pathway Primary immunodeficiency disease Ruxolitinib STAT1 GOF Impact of JAK Inhibitors in Pediatric Patients with STAT1 Gain of Function (GOF) Mutations-10 Children and Review of the Literature