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<p>Reactive arthritis (ReA) is a postinfectious inflammatory disorder that may be difficult to treat in refractory cases. We describe a 20-year-old man with HLA-B27–positive ReA presenting with arthritis, conjunctivitis, balanitis, and psoriasiform skin lesions. Conventional therapies, including antibiotics, nonsteroidal anti-inflammatory drugs, corticosteroids, and sulfasalazine, failed to control disease activity. Treatment with upadacitinib (15&#xa0;mg/day), a selective Janus kinase 1 inhibitor (JAK1), led to rapid improvement of joint, ocular, and cutaneous manifestations within three weeks. Corticosteroids were tapered and discontinued without relapse, and reduced-dose upadacitinib maintained remission for more than three months. This case highlights the potential role of JAK1 inhibition in ReA pathogenesis and suggests upadacitinib as a promising therapeutic option for refractory disease.</p>

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Progressive resolution of reactive arthritis treated with Upadacitinib

  • 期刊论文

  • 发表日期：

    2026年2月2日

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  • Jiawen Zhang,
  • Jingtao Zhang,
  • Fanping Yang,
  • Qiao Li,
  • Huibin Yin

摘要

Reactive arthritis (ReA) is a postinfectious inflammatory disorder that may be difficult to treat in refractory cases. We describe a 20-year-old man with HLA-B27–positive ReA presenting with arthritis, conjunctivitis, balanitis, and psoriasiform skin lesions. Conventional therapies, including antibiotics, nonsteroidal anti-inflammatory drugs, corticosteroids, and sulfasalazine, failed to control disease activity. Treatment with upadacitinib (15 mg/day), a selective Janus kinase 1 inhibitor (JAK1), led to rapid improvement of joint, ocular, and cutaneous manifestations within three weeks. Corticosteroids were tapered and discontinued without relapse, and reduced-dose upadacitinib maintained remission for more than three months. This case highlights the potential role of JAK1 inhibition in ReA pathogenesis and suggests upadacitinib as a promising therapeutic option for refractory disease.