Janus kinases inhibitors for coronavirus disease-2019: A pairwise and Bayesian network meta-analysis
BackgroundJAK (Janus kinases) inhibitors have been proposed as a promising treatment option for the coronavirus disease-2019 (COVID-19). However, the benefits of JAK inhibitors and the optimum thereof for COVID-19 have not been adequately defined.MethodsDatabases were searched from their inception d...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.973688/full |
| _version_ | 1811215938567012352 |
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| author | Jianyi Niu Jianyi Niu Zhiwei Lin Zhiwei Lin Zhenfeng He Zhenfeng He Xiaojing Yang Xiaojing Yang Lijie Qin Lijie Qin Shengchuan Feng Shengchuan Feng Lili Guan Lili Guan Luqian Zhou Luqian Zhou Rongchang Chen Rongchang Chen Rongchang Chen |
| author_facet | Jianyi Niu Jianyi Niu Zhiwei Lin Zhiwei Lin Zhenfeng He Zhenfeng He Xiaojing Yang Xiaojing Yang Lijie Qin Lijie Qin Shengchuan Feng Shengchuan Feng Lili Guan Lili Guan Luqian Zhou Luqian Zhou Rongchang Chen Rongchang Chen Rongchang Chen |
| author_sort | Jianyi Niu |
| collection | DOAJ |
| description | BackgroundJAK (Janus kinases) inhibitors have been proposed as a promising treatment option for the coronavirus disease-2019 (COVID-19). However, the benefits of JAK inhibitors and the optimum thereof for COVID-19 have not been adequately defined.MethodsDatabases were searched from their inception dates to 17 June 2022. Eligible studies included randomized controlled trials and observational studies. Extracted data were analyzed by pairwise and network meta-analysis. The primary outcome was the coefficient of mortality.ResultsTwenty-eight studies of 8,206 patients were included and assessed qualitatively (modified Jadad and Newcastle–Ottawa Scale scores). A pairwise meta-analysis revealed that JAK inhibitors effectively reduced the mortality (OR = 0.54; 95% CI: 0.46–0.63; P < 0.00001; I2 = 32%) without increasing the risk of adverse events (OR = 1.02; 95% CI: 0.88–1.18; P = 0.79; I2 = 12%). In a network meta-analysis, clinical efficacy benefits were seen among different types of JAK inhibitors (baricitinib, ruxolitinib, and tofacitinib) without the observation of a declined incidence of adverse events. The assessment of rank probabilities indicated that ruxolitinib presented the greatest likelihood of benefits regarding mortality and adverse events.ConclusionJAK inhibitors appear to be a promising treatment for COVID-19 concerning reducing mortality, and they do not increase the risk of adverse events vs. standard of care. A network meta-analysis suggests that mortality benefits are associated with specific JAK inhibitors, and among these, ruxolitinib presents the greatest likelihood of having benefits for mortality and adverse events.Systematic review registration[www.crd.york.ac.uk/prospero], identifier [CRD42022343338]. |
| first_indexed | 2024-04-12T06:31:51Z |
| format | Article |
| id | doaj.art-ccb40987c4ff45f9ad2a706ea94db30d |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-12T06:31:51Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-ccb40987c4ff45f9ad2a706ea94db30d2022-12-22T03:44:00ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-11-01910.3389/fmed.2022.973688973688Janus kinases inhibitors for coronavirus disease-2019: A pairwise and Bayesian network meta-analysisJianyi Niu0Jianyi Niu1Zhiwei Lin2Zhiwei Lin3Zhenfeng He4Zhenfeng He5Xiaojing Yang6Xiaojing Yang7Lijie Qin8Lijie Qin9Shengchuan Feng10Shengchuan Feng11Lili Guan12Lili Guan13Luqian Zhou14Luqian Zhou15Rongchang Chen16Rongchang Chen17Rongchang Chen18State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaRespiratory Mechanics Laboratory, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaState Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaRespiratory Mechanics Laboratory, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaState Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaRespiratory Mechanics Laboratory, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaState Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaRespiratory Mechanics Laboratory, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaState Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaRespiratory Mechanics Laboratory, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaState Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaRespiratory Mechanics Laboratory, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaState Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaRespiratory Mechanics Laboratory, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaState Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaRespiratory Mechanics Laboratory, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaState Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaRespiratory Mechanics Laboratory, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaKey Laboratory of Shenzhen Respiratory Diseases, Institute of Shenzhen Respiratory Diseases, Shenzhen People’s Hospital (The First Affiliated Hospital of Southern University of Science and Technology, The Second Clinical Medical College of Jinan University), Shenzhen, Guangdong, ChinaBackgroundJAK (Janus kinases) inhibitors have been proposed as a promising treatment option for the coronavirus disease-2019 (COVID-19). However, the benefits of JAK inhibitors and the optimum thereof for COVID-19 have not been adequately defined.MethodsDatabases were searched from their inception dates to 17 June 2022. Eligible studies included randomized controlled trials and observational studies. Extracted data were analyzed by pairwise and network meta-analysis. The primary outcome was the coefficient of mortality.ResultsTwenty-eight studies of 8,206 patients were included and assessed qualitatively (modified Jadad and Newcastle–Ottawa Scale scores). A pairwise meta-analysis revealed that JAK inhibitors effectively reduced the mortality (OR = 0.54; 95% CI: 0.46–0.63; P < 0.00001; I2 = 32%) without increasing the risk of adverse events (OR = 1.02; 95% CI: 0.88–1.18; P = 0.79; I2 = 12%). In a network meta-analysis, clinical efficacy benefits were seen among different types of JAK inhibitors (baricitinib, ruxolitinib, and tofacitinib) without the observation of a declined incidence of adverse events. The assessment of rank probabilities indicated that ruxolitinib presented the greatest likelihood of benefits regarding mortality and adverse events.ConclusionJAK inhibitors appear to be a promising treatment for COVID-19 concerning reducing mortality, and they do not increase the risk of adverse events vs. standard of care. A network meta-analysis suggests that mortality benefits are associated with specific JAK inhibitors, and among these, ruxolitinib presents the greatest likelihood of having benefits for mortality and adverse events.Systematic review registration[www.crd.york.ac.uk/prospero], identifier [CRD42022343338].https://www.frontiersin.org/articles/10.3389/fmed.2022.973688/fullCOVID-19JAK inhibitorsmortalityadverse eventsnetwork meta-analysis |
| spellingShingle | Jianyi Niu Jianyi Niu Zhiwei Lin Zhiwei Lin Zhenfeng He Zhenfeng He Xiaojing Yang Xiaojing Yang Lijie Qin Lijie Qin Shengchuan Feng Shengchuan Feng Lili Guan Lili Guan Luqian Zhou Luqian Zhou Rongchang Chen Rongchang Chen Rongchang Chen Janus kinases inhibitors for coronavirus disease-2019: A pairwise and Bayesian network meta-analysis Frontiers in Medicine COVID-19 JAK inhibitors mortality adverse events network meta-analysis |
| title | Janus kinases inhibitors for coronavirus disease-2019: A pairwise and Bayesian network meta-analysis |
| title_full | Janus kinases inhibitors for coronavirus disease-2019: A pairwise and Bayesian network meta-analysis |
| title_fullStr | Janus kinases inhibitors for coronavirus disease-2019: A pairwise and Bayesian network meta-analysis |
| title_full_unstemmed | Janus kinases inhibitors for coronavirus disease-2019: A pairwise and Bayesian network meta-analysis |
| title_short | Janus kinases inhibitors for coronavirus disease-2019: A pairwise and Bayesian network meta-analysis |
| title_sort | janus kinases inhibitors for coronavirus disease 2019 a pairwise and bayesian network meta analysis |
| topic | COVID-19 JAK inhibitors mortality adverse events network meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.973688/full |
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