The evaluation of JAK inhibitors on effect and safety in alopecia areata: a systematic review and meta-analysis of 2018 patients.
The evaluation of JAK inhibitors on effect and safety in alopecia areata: a systematic review and meta-analysis of 2018 patients.
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DOI：
10.3389/fimmu.2023.1195858
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发表时间：
2023
影响因子：
7.3
通讯作者：
中科院分区：
文献类型：
--
作者：
JAK抑制剂治疗各种自身免疫性疾病，但目前缺乏治疗斑秃的最新系统评价。通过系统评价和荟萃分析，评价JAK抑制剂治疗斑秃的特异性疗效和安全性。检索了截至2022年5月30日PubMed、Embase、Web of Science和Clinical Trials中的合格研究。我们参加了随机对照试验和应用JAK抑制剂治疗斑秃的观察性研究。6项随机对照试验（1455例患者）显示SALT 50（比值比[OR]，5.08; 95%置信区间[CI]，3.49-7.38），SALT 90（OR，7.40; 95% CI，4.34-12.67）和SALT评分变化（加权平均差异[WSD]，5.55; 95% CI，2.60-8.50）。26项观察性研究（563例SALT 5患者）的比例为0.71（95% CI，0.65-0.78），SALT 50为0.54（95% CI 0.46-0.63），SALT 90为0.33（95% CI，0.24-0.42），SALT评分（WSD，-2.18; 95% CI，-3.12至-1.23）与基线相比。1508例患者中有921例发生任何不良反应;共有30例患者因不良反应而中止试验。符合纳入标准的随机对照试验很少，合格数据不足。JAK抑制剂对斑秃有效，但与风险增加有关。
JAK inhibitors treat various autoimmune diseases, but an updated systematic review in treating alopecia areata is currently lacking. Evaluate the specific efficacy and safety of JAK inhibitors in alopecia areata by systematic review and meta-analysis. Eligible studies in PubMed, Embase, Web of Science, and Clinical Trials up to May 30, 2022, were searched. We enrolled in randomized controlled trials and observational studies of applying JAK inhibitors in alopecia areata. 6 randomized controlled trials with 1455 patients exhibited SALT50 (odd ratio [OR], 5.08; 95% confidence interval [CI], 3.49-7.38), SALT90 (OR, 7.40; 95% CI, 4.34-12.67) and change in SALT score (weighted mean difference [WSD], 5.55; 95% CI, 2.60-8.50) compared to the placebo. The proportion of 26 observational studies with 563 patients of SALT5 was 0.71(95% CI, 0.65-0.78), SALT50 was 0.54(95% CI 0.46-0.63), SALT90 was 0.33(95% CI, 0.24-0.42), and SALT score (WSD, -2.18; 95% CI, -3.12 to -1.23) compared with baseline. Any adverse effects occurred in 921 of 1508 patients; a total of 30 patients discontinued the trial owing to adverse reactions. Few randomized controlled trials met the inclusion criteria and insufficiency of eligible data. JAK inhibitors are effective in alopecia areata, although associated with an increased risk.
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