VEXAS 101 — Understanding VEXAS Syndrome | VEXAS Foundation
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VEXAS 101

Everything you need to understand VEXAS syndrome — written for patients, caregivers, and anyone looking for answers.

What is VEXAS syndrome?

VEXAS (Vacuoles, E1 enzyme, X-linked, Autoinflammatory, Somatic) is a recently discovered inflammatory disease caused by a somatic mutation in the UBA1 gene. Unlike inherited conditions, this mutation develops during a person's lifetime — it is not passed from parent to child.

Co-discovered in 2020 by Drs. David Beck and Peter Grayson at the NIH and published in the New England Journal of Medicine, VEXAS affects approximately 1 in 4,000 men over age 50 in the United States — making it more common than many well-known inflammatory conditions, yet still widely unrecognized.

What does VEXAS stand for?
VEXAS

Vacuoles — abnormal spaces seen in bone marrow cells

E1 enzyme — the UBA1 enzyme that is mutated

X-linked — the UBA1 gene is on the X chromosome

Autoinflammatory — the body attacks its own tissues

Somatic — the mutation happens during life, not inherited

Symptoms & Diagnosis

VEXAS can mimic many other conditions — which is why the average time to diagnosis is 3–5 years. Symptoms span multiple organ systems and vary significantly between patients.

Recurrent Fevers
Unexplained, often high fevers that return repeatedly without obvious cause
Anemia
Low red blood cell counts causing fatigue, weakness, and shortness of breath
Skin Inflammation
Rashes, skin lesions, or ear and nose cartilage swelling (relapsing polychondritis)
Lung Involvement
Pulmonary infiltrates, chronic cough, and breathing difficulties
Blood Disorders
Myelodysplastic features and low platelet counts (thrombocytopenia)
Joint Pain
Arthritis-like joint inflammation, often previously diagnosed as rheumatoid arthritis

Frequently misdiagnosed as: MDS (myelodysplastic syndrome), relapsing polychondritis, rheumatoid arthritis, Sweet syndrome, or other autoinflammatory conditions. If you've received one of these diagnoses with ongoing unexplained symptoms, ask your physician about UBA1 testing.

How is it confirmed? A genetic test of your blood checks for a pathogenic UBA1 mutation that confirms VEXAS syndrome. Testing is widely available, and our network of VEXAS medical centers provides specialized expertise for diagnosis, treatment, and ongoing care. Find a VEXAS medical center →

Treatment Landscape

There are currently no FDA-approved treatments specifically for VEXAS. Physicians use existing approved drugs off-label, while clinical trials work toward better options.

Common first-line (off-label)
Corticosteroids (Prednisone)

Often the first treatment used for inflammation control. Provides short-term relief but long-term use carries significant side effects including bone density loss and immune suppression.

Off-label / Investigational
Azacitidine

A hypomethylating agent showing promise in patients who don't respond to steroids. Currently under study in a Phase II NIH clinical trial (view trial →).

Off-label / Investigational
JAK Inhibitors (Ruxolitinib)

Being studied for inflammatory suppression in VEXAS. Active trials ongoing at NYU Langone and Mayo Clinic. Results expected 2027.

Potentially curative
Bone Marrow Transplant (BMT / HSCT)

Allogeneic stem cell transplant is the only known potential cure for VEXAS. It is not appropriate for all patients. Many patients in our community have navigated this decision — read their stories →

Treatment decisions should always be made in consultation with an experienced physician. VEXAS is complex and management varies significantly by patient. Consider seeking care at a VEXAS medical center.

Patient Stories

Real stories from people living with VEXAS — their journeys to diagnosis, their treatment decisions, and their lives today.

Patient photo
(with consent)

"After three years of unexplained fevers and being told nothing was wrong, I finally had an answer. Finding this foundation was the first time I felt like someone truly understood what I was going through."

James M.
Diagnosed with VEXAS, 2022 · Atlanta, GA
Read James's full story →
Patient photo
(with consent)

"After my bone marrow transplant, I was terrified and didn't know what to expect. The Foundation's resources helped me understand the process and connected me with others who had been through it."

Foundation President
Personal experience with VEXAS and BMT
Read full story →

Frequently Asked Questions

Is VEXAS inherited? Can I pass it to my children?
No. VEXAS is caused by a somatic (acquired) mutation that develops during your lifetime — it is not inherited from parents and cannot be passed to your children.
Does VEXAS only affect men?
VEXAS predominantly affects men because the UBA1 gene is on the X chromosome. Men have only one copy, so a single mutation causes disease. Women have two X chromosomes providing a backup, though female cases have been reported and are an active area of research.
Why does VEXAS appear to affect fewer Black patients?
This is an active area of inquiry. Researchers are investigating whether there is a biological explanation, or whether disparities in access to testing and specialty care contribute to underdiagnosis. The research community is actively studying this important question.
How do I get tested for VEXAS?
Ask your physician about UBA1 mutation testing via a blood or bone marrow biopsy. Testing is widely available, and our network of VEXAS medical centers provides specialized expertise for diagnosis, treatment, and ongoing care.
What is the prognosis for VEXAS?
Prognosis varies widely depending on disease severity, organ involvement, and treatment response. Bone marrow transplant offers a potential cure for eligible patients. Research into better treatments is ongoing and rapidly advancing — the pace of discovery since 2020 has been remarkable.
Are there clinical trials I can join?
Yes. Several trials are actively recruiting VEXAS patients, including a Phase II NIH study on azacitidine and a JAK inhibitor study at NYU and Mayo Clinic. Browse current studies and eligibility criteria on ClinicalTrials.gov.

Resources

Curated resources for patients, caregivers, and healthcare providers.

Free Patient Guide
VEXAS 101 Syndrome Resource Guide
35 pages · October 2025 · Created by the VEXAS Foundation Inc.
We refer to this resource guide as “VEXAS 101” because it serves as a clear starting point for understanding VEXAS syndrome. It is designed to help patients, caregivers, healthcare providers, and loved ones better understand the disease, support conversations with physicians who may be unfamiliar with VEXAS, and increase awareness through reliable, accessible information. We believe education is empowering, and our goal is to help shorten the time to diagnosis, improve clinical care, and ultimately lead to better outcomes for everyone affected by VEXAS.
Get the guide

Medical Disclaimer: The VEXAS 101 Resource Guide and information on this page are provided for general information and educational purposes only. Only healthcare professionals can properly advise patients about VEXAS syndrome and its related treatment options. This content does not constitute medical advice.

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