Novel treatments for novel side effects: a case report and review of baricitinib use in the treatment of chronic inflammatory demyelinating polyneuropathy caused by immune checkpoint inhibitor use

Abstract

Immune checkpoint inhibitors (ICIs) have transformed the landscape of solid cancer management. These drugs carry a risk of novel side effects, which have become known as immune-related adverse events (irAEs).Traditionally, irAEs have been managed empirically with corticosteroids. A subset of these may be steroid refractory and as more evidence emerges about their distinct pathogeneses, a more tailored approach is required. Here, we report the use of a Janus kinase (JAK) inhibitor, baricitinib, in a patient with chronic inflammatory demyelinating polyneuropathy secondary to ICI use. We also review the current literature with regards to the use of these inhibitors in the management of irAEs.Modulation of the JAK pathway warrants further investigation in the targeted management of irAEs.