USE OF UPADACITINIB IN 2 CASES OF REFRACTORY SYSTEMIC LUPUS ERYTHEMATOSUS
Bibliographic record
Abstract
PV301 / #634 Case Report Poster Topic: AS24 - SLE-Treatment Introduction Upadacitinib, a selective JAK inhibitor, is under evaluation in clinical trials alone and in combination with elsubrutinib for systemic lupus erythematosus (SLE). In our cohort, it has been employed off-label in 2 refractory cases of SLE with promising outcomes. Case Presentation With Investigation Two female patients with long-standing, refractory SLE were treated with upadacitinib 15 mg/day after multiple therapeutic failures. Clinical history, prior treatments, response to upadacitinib, and disease activity were analyzed. Literature Review • Case 1: A 54-year-old woman with SLE involving articular, hematological, cutaneous, and neurological (lupus headache) domains, alongside severe fatigue meeting chronic fatigue syndrome criteria. The patient failed conventional treatments, including belimumab. Upadacitinib 15 mg/day was initiated, resulting in complete disease remission and significant improvement in fatigue and headache. The patient has sustained remission for 18 months. • Case 2: A 59-year-old woman with a 39-year history of SLE predominantly involving articular, cutaneous, hematological, and serosal domains. After multiple treatments, including methotrexate, leflunomide, mycophenolate, belimumab, rituximab, anifrolumab, and off-label baricitinib, she exhibited persistent disease activity. Upadacitinib 15 mg/day was started, leading to low disease activity within 3 months. However, the patient continues to require corticosteroids. Discussion Upadacitinib may represent a promising therapeutic option for refractory SLE, achieving disease remission or low disease activity in patients unresponsive to conventional and biological therapies. Further studies are needed to evaluate its safety and efficacy in broader SLE populations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.005 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".