PMID- 34455413
OWN - NLM
STAT- MEDLINE
DCOM- 20220708
LR  - 20220924
IS  - 1421-9832 (Electronic)
IS  - 1018-8665 (Print)
IS  - 1018-8665 (Linking)
VI  - 238
IP  - 4
DP  - 2022
TI  - Efficacy and Safety of Janus Kinase Inhibitors for the Treatment of Atopic 
      Dermatitis: A Systematic Review and Meta-Analysis.
PG  - 725-735
LID - 10.1159/000518541 [doi]
AB  - BACKGROUND: Current therapeutic options for atopic dermatitis (AD) are limited. 
      Janus kinase (JAK) inhibitors may be viable alternatives. OBJECTIVES: To assess 
      the efficacy and safety of JAK inhibitors for AD treatment. METHODS: We searched 
      PubMed, Embase, the Cochrane Controlled Register of Trials, Web of Science, 
      Global Resource of Eczema Trials database, and ClinicalTrials.gov from inception 
      to September 1, 2020. Randomized clinical trials (RCTs) comparing JAK inhibitors 
      with placebo/vehicle treatment for AD patients were included. The primary study 
      outcomes included (1) the change (%) from the Eczema Area and Severity Index 
      (EASI) baseline expressed as weighted mean difference (WMD) and 95% confidence 
      interval (95% CI), and (2) the Investigator's Global Assessment (IGA) response 
      and safety outcomes expressed as relative risk (RR) and 95% CI. RESULTS: We 
      included 14 RCTs published in 13 studies (3,822 patients). Treatment with JAK 
      inhibitors significantly improved IGA response (RR 2.83, 95% CI 2.25-3.56, p < 
      0.001) and EASI score (WMD -28.82, 95% CI -34.48 to -23.16, p < 0.001). JAK 
      inhibitor treatment achieved the largest improvement in both IGA response (RR 
      3.59, 95% CI 2.66-4.84, p < 0.001) and EASI score (WMD -42.00, 95% CI -48.64 to 
      -35.36, p < 0.001) by week 4 of treatment. Topical JAK inhibitors were 
      significantly more efficacious than oral inhibitors. Upadacitinib treatment for 4 
      weeks was most effective in reducing EASI score (WMD -53.92, 95% CI -69.26 to 
      -38.58, p < 0.001), while abrocitinib for 4 weeks led to the most effective IGA 
      response (RR 5.47, 95% CI 2.74-10.93, p < 0.001). There was no difference in the 
      frequency of adverse events (AEs) leading to discontinuation; however, JAK 
      inhibitors use, especially abrocitinib, led to a higher incidence of 
      treatment-emergent AEs (RR 1.25, 95% CI 1.10-1.42, p = 0.001). CONCLUSION: Our 
      results imply that JAK inhibitors are an effective and safe AD treatment. 
      Nevertheless, further trials with longer duration and head-to-head comparisons of 
      different JAK inhibitors are needed.
CI  - (c) 2021 The Author(s). Published by S. Karger AG, Basel.
FAU - Li, Chenyang
AU  - Li C
AD  - Department of Dermatology, Shengjing Hospital of China Medical University, 
      Shenyang, China.
FAU - Sun, Xun
AU  - Sun X
AD  - Department of Immunology, China Medical University, Shenyang, China.
FAU - Zhao, Kun
AU  - Zhao K
AD  - Department of Sport Medicine, Zhejiang University School of Medicine, Hangzhou, 
      China.
FAU - Meng, Fanxiang
AU  - Meng F
AD  - Department of Immunology, China Medical University, Shenyang, China.
FAU - Li, Lin
AU  - Li L
AD  - Department of Dermatology, Shengjing Hospital of China Medical University, 
      Shenyang, China.
FAU - Mu, Zhenzhen
AU  - Mu Z
AD  - Department of Dermatology, Shengjing Hospital of China Medical University, 
      Shenyang, China.
FAU - Han, Xiuping
AU  - Han X
AD  - Department of Dermatology, Shengjing Hospital of China Medical University, 
      Shenyang, China.
LA  - eng
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20210827
PL  - Switzerland
TA  - Dermatology
JT  - Dermatology (Basel, Switzerland)
JID - 9203244
RN  - 0 (Immunoglobulin A)
RN  - 0 (Janus Kinase Inhibitors)
SB  - IM
MH  - *Dermatitis, Atopic/drug therapy
MH  - *Eczema
MH  - Humans
MH  - Immunoglobulin A/therapeutic use
MH  - *Janus Kinase Inhibitors/adverse effects
MH  - Randomized Controlled Trials as Topic
MH  - Treatment Outcome
PMC - PMC9393843
OTO - NOTNLM
OT  - Atopic dermatitis
OT  - Janus kinase inhibitors
OT  - Meta-analysis
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2021/08/30 06:00
MHDA- 2022/07/09 06:00
PMCR- 2021/08/27
CRDT- 2021/08/29 21:02
PHST- 2021/02/19 00:00 [received]
PHST- 2021/06/26 00:00 [accepted]
PHST- 2021/08/30 06:00 [pubmed]
PHST- 2022/07/09 06:00 [medline]
PHST- 2021/08/29 21:02 [entrez]
PHST- 2021/08/27 00:00 [pmc-release]
AID - 000518541 [pii]
AID - drm-0238-0725 [pii]
AID - 10.1159/000518541 [doi]
PST - ppublish
SO  - Dermatology. 2022;238(4):725-735. doi: 10.1159/000518541. Epub 2021 Aug 27.