Efficacy and safety of JAK inhibitors in the treatment of psoriasis and psoriatic arthritis: a systematic review and meta-analysis
Abstract Background JAK inhibitors are a relatively new class of medications that may be useful in the treatment of moderate-to-severe psoriasis and psoriatic arthritis (PsA). The objective of this study was to determine the efficacy of several JAK inhibitors in treating psoriasis and PsA and examin...
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| Format: | Article |
| Language: | English |
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BMC
2022-09-01
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| Series: | BMC Rheumatology |
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| Online Access: | https://doi.org/10.1186/s41927-022-00287-7 |
| _version_ | 1811253725561356288 |
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| author | Samantha Sarabia Brandan Ranjith Sahil Koppikar Don Thiwanka Wijeratne |
| author_facet | Samantha Sarabia Brandan Ranjith Sahil Koppikar Don Thiwanka Wijeratne |
| author_sort | Samantha Sarabia |
| collection | DOAJ |
| description | Abstract Background JAK inhibitors are a relatively new class of medications that may be useful in the treatment of moderate-to-severe psoriasis and psoriatic arthritis (PsA). The objective of this study was to determine the efficacy of several JAK inhibitors in treating psoriasis and PsA and examine safety concerns. Methods MEDLINE, Cochrane and EMBASE were searched for randomized controlled trials and observational studies comparing any JAK inhibitor to placebo. The primary outcomes were a 75% improvement in the Psoriasis Area and Severity Index (PASI75) and a 20% improvement in the American College of Rheumatology composite score (ACR20). A secondary outcome was the proportion of patients achieving a “0” or “1” on the static Physician Global Assessment scale. Odds ratios were used to compare the proportion of patients reaching these targets in the max dose intervention group vs. the placebo group. A random effects model was used to account for heterogeneity. Results In total, 15 RCTs were included in the study and no observational studies. This encompassed 6757 patients in total. When the results were combined, the calculated odds ratio for PASI75 amongst tofacitinib vs. placebo was OR 14.35 [95%CI 7.65, 26.90], for PASI75 amongst non-tofacitinib JAK inhibitors vs. placebo it was OR 6.42 [95%CI 4.89, 8.43], for ACR20 amongst all JAK inhibitors versus placebo was OR 5.87 [95%CI 4.39, 7.85]. There was no significant difference in prevalence of serious adverse events between intervention and control in any of these studies. Conclusion JAK inhibitors show promise for safely treating moderate-to-severe psoriasis and psoriatic arthritis. |
| first_indexed | 2024-04-12T16:55:25Z |
| format | Article |
| id | doaj.art-2d9cb82a9cdd41609026a192c859d904 |
| institution | Directory Open Access Journal |
| issn | 2520-1026 |
| language | English |
| last_indexed | 2024-04-12T16:55:25Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Rheumatology |
| spelling | doaj.art-2d9cb82a9cdd41609026a192c859d9042022-12-22T03:24:15ZengBMCBMC Rheumatology2520-10262022-09-016111610.1186/s41927-022-00287-7Efficacy and safety of JAK inhibitors in the treatment of psoriasis and psoriatic arthritis: a systematic review and meta-analysisSamantha Sarabia0Brandan Ranjith1Sahil Koppikar2Don Thiwanka Wijeratne3School of Medicine, Queen’s UniversityFaculty of Arts and Science, Queen’s UniversityDivision of Rheumatology, Department of Medicine, University of Toronto, 1 King’s College CircleDivision of General Internal Medicine, Department of Medicine, Queen’s UniversityAbstract Background JAK inhibitors are a relatively new class of medications that may be useful in the treatment of moderate-to-severe psoriasis and psoriatic arthritis (PsA). The objective of this study was to determine the efficacy of several JAK inhibitors in treating psoriasis and PsA and examine safety concerns. Methods MEDLINE, Cochrane and EMBASE were searched for randomized controlled trials and observational studies comparing any JAK inhibitor to placebo. The primary outcomes were a 75% improvement in the Psoriasis Area and Severity Index (PASI75) and a 20% improvement in the American College of Rheumatology composite score (ACR20). A secondary outcome was the proportion of patients achieving a “0” or “1” on the static Physician Global Assessment scale. Odds ratios were used to compare the proportion of patients reaching these targets in the max dose intervention group vs. the placebo group. A random effects model was used to account for heterogeneity. Results In total, 15 RCTs were included in the study and no observational studies. This encompassed 6757 patients in total. When the results were combined, the calculated odds ratio for PASI75 amongst tofacitinib vs. placebo was OR 14.35 [95%CI 7.65, 26.90], for PASI75 amongst non-tofacitinib JAK inhibitors vs. placebo it was OR 6.42 [95%CI 4.89, 8.43], for ACR20 amongst all JAK inhibitors versus placebo was OR 5.87 [95%CI 4.39, 7.85]. There was no significant difference in prevalence of serious adverse events between intervention and control in any of these studies. Conclusion JAK inhibitors show promise for safely treating moderate-to-severe psoriasis and psoriatic arthritis.https://doi.org/10.1186/s41927-022-00287-7Psoriatic arthritisPsoriasisJAK inhibitorsTofacitinibUpadacitinib |
| spellingShingle | Samantha Sarabia Brandan Ranjith Sahil Koppikar Don Thiwanka Wijeratne Efficacy and safety of JAK inhibitors in the treatment of psoriasis and psoriatic arthritis: a systematic review and meta-analysis BMC Rheumatology Psoriatic arthritis Psoriasis JAK inhibitors Tofacitinib Upadacitinib |
| title | Efficacy and safety of JAK inhibitors in the treatment of psoriasis and psoriatic arthritis: a systematic review and meta-analysis |
| title_full | Efficacy and safety of JAK inhibitors in the treatment of psoriasis and psoriatic arthritis: a systematic review and meta-analysis |
| title_fullStr | Efficacy and safety of JAK inhibitors in the treatment of psoriasis and psoriatic arthritis: a systematic review and meta-analysis |
| title_full_unstemmed | Efficacy and safety of JAK inhibitors in the treatment of psoriasis and psoriatic arthritis: a systematic review and meta-analysis |
| title_short | Efficacy and safety of JAK inhibitors in the treatment of psoriasis and psoriatic arthritis: a systematic review and meta-analysis |
| title_sort | efficacy and safety of jak inhibitors in the treatment of psoriasis and psoriatic arthritis a systematic review and meta analysis |
| topic | Psoriatic arthritis Psoriasis JAK inhibitors Tofacitinib Upadacitinib |
| url | https://doi.org/10.1186/s41927-022-00287-7 |
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