Formulation and Systemic Therapy

Q: What does this research mean for the field?

Patients receiving JAK-1 inhibitors such as upadacitinib are at risk for severe neuro-ophthalmic varicella-zoster virus infections, underscoring the necessity of structured vaccination reviews prior to initiating immunomodulatory therapy. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Taherah Khan; Foteini Moniati; D. Thompson

doi:10.1093/ced/llag395

September 11, 2026Clinical and Experimental DermatologyOpen Access

Formulation and Systemic Therapy

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Key Points

Document a severe presentation of varicella-zoster virus infection presenting as herpes zoster ophthalmicus and encephalitis during treatment with upadacitinib.
Clinical evaluation of an 81-year-old woman receiving the JAK-1 inhibitor upadacitinib for rheumatoid arthritis.
Medication reconciliation to evaluate the timing of immunomodulatory therapy during the presentation of symptoms.
Development of herpes zoster ophthalmicus with significant ophthalmic morbidity and concurrent varicella-zoster virus encephalitis.
Continued administration of JAK-1 inhibition during early disease presentations prior to diagnosis.

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Implication

Case report reveals severe neuro-ophthalmic varicella-zoster virus infection during upadacitinib therapy, highlighting the need for vaccination review before targeted immunomodulation.

Abstract

An 81-year-old woman receiving upadacitinib, a JAK-1 inhibitor, for rheumatoid arthritis developed herpes zoster ophthalmicus with significant ophthalmic morbidity and varicella-zoster virus encephalitis. Medication reconciliation revealed continued JAK-1 inhibition during early presentations. This case highlights the importance of structured vaccination review and documentation before initiating targeted immunomodulatory therapy and underscores the potential severity of neuro-ophthalmic VZV in patients receiving JAK inhibition.

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Khan et al. (2026) studied this question.

synapsesocial.com/papers/6aa7b3850926e14a848b285e https://doi.org/10.1093/ced/llag395

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Formulation and Systemic Therapy

Key Points

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Implication

Abstract

Discussion

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Formulation and Systemic Therapy

Key Points

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Implication

Abstract

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Cite This Study

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