Formulation and Systemic Therapy.

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.