{"doi":"10.1016/j.xops.2024.100627","title":"Systemic Treatment with the Janus Kinase Inhibitor Baricitinib in Ocular Chronic Graft-versus-Host Disease","abstract":"Objective: To investigate the effects of oral baricitinib on ocular surface disease (OSD) in patients with chronic graft-versus-host disease (cGVHD). Design: Prospective phase 1 to 2 single institution trial. Subjects: Eighteen patients with ocular graft-versus-host-disease (oGVHD) and systemic steroid-refractory cGVHD. Methods: Oral baricitinib (2 mg and 4 mg) was administered daily for up to 12 months in an intrapatient dose-escalation design. National Institutes of Health (NIH) oGVHD score, vision, corneal Oxford staining (COS), tear break-up time (TBUT), Schirmer I test (ST) without anesthesia, and microliter tear equivalent conversion were assessed at baseline, 6 months (primary efficacy end point), and 12 months if patients remained on the drug. Main Outcome Measures: Improvement in NIH oGVHD score, COS, TBUT, and ST results in patients with and without conjunctival fibrosis at 6 months. Results: = 0.018), TBUT 8.62 seconds, ST 9.12 mm (5.4 μl); 12 months: COS 0, TBUT 10.29 seconds, ST 16.88 mm (10.6 μl). Vision was stable in all groups. Two patients developed asymptomatic, self-limited conjunctival papillomas, and 1 patient developed uncomplicated bacterial conjunctivitis twice. No dose limiting toxicity was observed. Severe adverse events with hospitalizations for possible drug-related systemic infections occurred in 5 patients. Conclusions: Systemic baricitinib was well-tolerated, improved NIH oGVHD scores and OSD parameters in patients with oGVHD, with the greatest benefits observed in patients without pre-existing conjunctival fibrosis. Conjunctival fibrosis may affect outcomes and should be considered in patient selection for clinical trials. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.","journal":"Ophthalmology Science","year":2024,"id":460157,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9653,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":385181,"name":"Noa G. Holtzman","orcid":"0000-0002-5706-1109","position":1,"is_corresponding":false},{"id":1119270,"name":"Aaron T. Zhao","orcid":"0000-0001-5638-8962","position":2,"is_corresponding":false},{"id":465337,"name":"Chantal Cousineau-Krieger","orcid":"0000-0003-1008-8950","position":3,"is_corresponding":false},{"id":378889,"name":"Susan Vitale","orcid":"0000-0002-5972-6848","position":4,"is_corresponding":false},{"id":347274,"name":"Edmond J. FitzGibbon","orcid":"0000-0001-6855-7540","position":5,"is_corresponding":false},{"id":731892,"name":"Debbie Payne","orcid":null,"position":6,"is_corresponding":false},{"id":1288277,"name":"Janine Newgen","orcid":null,"position":7,"is_corresponding":false},{"id":1288278,"name":"Celestina Igbinosun","orcid":null,"position":8,"is_corresponding":false},{"id":313703,"name":"Annie Im","orcid":"0000-0002-0973-7100","position":9,"is_corresponding":false},{"id":109199,"name":"Cody J. Peer","orcid":"0000-0001-9395-3473","position":10,"is_corresponding":false},{"id":109200,"name":"William D. Figg","orcid":"0000-0003-2428-5613","position":11,"is_corresponding":false},{"id":286643,"name":"Edward W. Cowen","orcid":"0000-0003-1918-4324","position":12,"is_corresponding":false},{"id":385179,"name":"Jacqueline W. Mays","orcid":"0000-0002-4472-9974","position":13,"is_corresponding":false},{"id":313707,"name":"Steven Z. Pavletic","orcid":"0000-0001-9111-9354","position":14,"is_corresponding":false},{"id":347273,"name":"M. Teresa Magone","orcid":"0000-0001-6370-6295","position":15,"is_corresponding":false},{"id":1287669,"name":"Taylor McManus","orcid":"0000-0002-1724-6109","position":0,"is_corresponding":true}],"reference_count":30,"raw_metadata":null,"created_at":"2026-07-19T02:04:03.568045Z","pmid":"39605875","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}