PMID- 35280877
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220317
IS  - 2296-858X (Print)
IS  - 2296-858X (Electronic)
IS  - 2296-858X (Linking)
VI  - 9
DP  - 2022
TI  - A Scoping Review on Use of Drugs Targeting the JAK/STAT Pathway in Psoriasis.
PG  - 754116
LID - 10.3389/fmed.2022.754116 [doi]
LID - 754116
AB  - INTRODUCTION: The Janus kinase-signal transducer and activator of transcription 
      (JAK/STAT) pathway are known to be involved in inflammatory immune-mediated skin 
      diseases, including psoriasis. The development of drugs targeting the JAK/STAT 
      signaling pathway presents new treatment opportunities for psoriasis. However, 
      the application of JAK inhibitors for the treatment of dermatological disorders 
      is still in its early stages of development. This review summarizes available 
      evidence in an attempt to identify knowledge gaps for conducting further research 
      studies and improving clinical decision-making. OBJECTIVE: The objective of this 
      study is to conduct a scoping review of the use of drugs targeting the JAK/STAT 
      pathway in the treatment of psoriasis. METHODS: A priori protocol for scoping 
      review was published in 2019. The Joanna Briggs Institute Reviewer's Manual and 
      the PRISMA Extension for Scoping Review were used for the review. MEDLINE, 
      EMBASE, CINAHL, Scopus, and Web of Science databases and ClinicalTrials registry 
      were referred to in April 2019 and March 2021, respectively. References in 
      English involving evidence on the use of drugs targeting the JAK/STAT pathway in 
      patients with psoriasis were included. Data charting was performed by two authors 
      using tables and figures. RESULTS: The evidence found on the efficacy and safety 
      of drugs targeting the JAK/STAT pathway in patients with psoriasis comes from 118 
      articles reporting the results of 34 randomized clinical trials (RCTs). Nine 
      different drugs administered through various routes were identified (systemic: 
      peficitinib, baricitinib, solcitinib, itacitinib, abrocitinib, deucravacitinib, 
      and brepocitinib; topical: ruxolitinib; and both: tofacitinib). Knowledge 
      articles are mainly created and published by pharmaceutical companies and authors 
      through their own funding or by those related to them. Only tofacitinib and 
      deucravacitinib have undergone phase III clinical trials, being the only ones 
      tested with active comparators etanercept and apremilast, respectively. 
      Proportions of Psoriasis Area and Severity Index (PASI) and Physician's Global 
      Assessment (PGA) were the efficacy variables most frequently studied in systemic 
      treatments. Only two RCTs declared the safety data collected by systematic 
      assessment; the only systemic drug with phase III data was tofacitinib. 
      Tofacitinib 5 mg two times daily (BID)/10 mg BID efficacy was compared with 
      etanercept 50 mg/week and a placebo. At 12-16 weeks, PASI 75/PGA 01 ranges were 
      as follows: 38.07-80%/37.16-67.4% for tofacitinib 5 mg BID; 54.79-100%/50-75.6% 
      for tofacitinib 10 mg BID; 58.8/66.8% for etanercept, date from one only study; 
      and 0-33.3%/9.04-33.3% for the placebo group. Other drugs in earlier stages of 
      development showed values within these ranges. The most frequent adverse events 
      (AEs) were nasopharyngitis and upper respiratory tract infections in all 
      treatment groups. CONCLUSION: There is increasing evidence on the use of drugs 
      targeting the JAK/STAT pathway as a treatment for psoriasis, although they are in 
      the early phases of development. The trials conducted to date have been financed 
      directly or indirectly by the pharmaceutical industry, which must be taken into 
      account when interpreting the results of the trials. Psoriasis treatment is 
      currently symptomatic and could potentially present a significant risk of 
      toxicity. Therefore, the design of principal efficacy outcome measures 
      considering the impact of the outcome on quality of life and a drug assessment 
      methodology aimed at improving safety would probably strengthen the evidence and 
      decision-making process.
CI  - Copyright (c) 2022 Gomez-Garcia, Gomez-Arias, Montilla-Lopez, Hernandez-Parada, 
      Sanz-Cabanillas, Ruano and Parra-Peralbo.
FAU - Gomez-Garcia, Francisco
AU  - Gomez-Garcia F
AD  - Inflammatory Immune-Mediated Chronic Skin Diseases' Laboratory, Insituto 
      Maimonides de Investigacion Biomedica de Cordoba (IMIBIC), Reina Sofia University 
      Hospital, University of Cordoba, Cordoba, Spain.
AD  - Department of Dermatology, Reina Sofia University Hospital, Cordoba, Spain.
FAU - Gomez-Arias, Pedro Jesus
AU  - Gomez-Arias PJ
AD  - Inflammatory Immune-Mediated Chronic Skin Diseases' Laboratory, Insituto 
      Maimonides de Investigacion Biomedica de Cordoba (IMIBIC), Reina Sofia University 
      Hospital, University of Cordoba, Cordoba, Spain.
AD  - Department of Dermatology, Reina Sofia University Hospital, Cordoba, Spain.
FAU - Montilla-Lopez, Ana
AU  - Montilla-Lopez A
AD  - Inflammatory Immune-Mediated Chronic Skin Diseases' Laboratory, Insituto 
      Maimonides de Investigacion Biomedica de Cordoba (IMIBIC), Reina Sofia University 
      Hospital, University of Cordoba, Cordoba, Spain.
FAU - Hernandez-Parada, Jorge
AU  - Hernandez-Parada J
AD  - Department of Pharmacology, Reina Sofia University Hospital, Cordoba, Spain.
FAU - Sanz-Cabanillas, Juan Luis
AU  - Sanz-Cabanillas JL
AD  - Inflammatory Immune-Mediated Chronic Skin Diseases' Laboratory, Insituto 
      Maimonides de Investigacion Biomedica de Cordoba (IMIBIC), Reina Sofia University 
      Hospital, University of Cordoba, Cordoba, Spain.
AD  - Department of Dermatology, Reina Sofia University Hospital, Cordoba, Spain.
FAU - Ruano, Juan
AU  - Ruano J
AD  - Inflammatory Immune-Mediated Chronic Skin Diseases' Laboratory, Insituto 
      Maimonides de Investigacion Biomedica de Cordoba (IMIBIC), Reina Sofia University 
      Hospital, University of Cordoba, Cordoba, Spain.
AD  - Department of Dermatology, Reina Sofia University Hospital, Cordoba, Spain.
FAU - Parra-Peralbo, Esmeralda
AU  - Parra-Peralbo E
AD  - Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, 
      Spain.
LA  - eng
PT  - Systematic Review
DEP - 20220225
PL  - Switzerland
TA  - Front Med (Lausanne)
JT  - Frontiers in medicine
JID - 101648047
PMC - PMC8914468
OTO - NOTNLM
OT  - JAK inhibitors
OT  - abrocitinib
OT  - autoimmune diseases
OT  - deucravacitinib
OT  - psoriasis
OT  - ruxolitinib
OT  - tofacitinib
COIS- FG-G has received honoraria for research from Pfizer and for lecturing from 
      AbbVie, Janssen-Cilag, and Novartis. JR has received honoraria for lecturing and 
      grants for research from Pfizer, honoraria for lecturing from Janssen-Cilag and 
      Novartis, and other financial benefits from AbbVie and Novartis. The remaining 
      authors declare that the research was conducted in the absence of any commercial 
      or financial relationships that could be construed as a potential conflict of 
      interest.
EDAT- 2022/03/15 06:00
MHDA- 2022/03/15 06:01
PMCR- 2022/02/25
CRDT- 2022/03/14 05:15
PHST- 2021/08/05 00:00 [received]
PHST- 2022/01/17 00:00 [accepted]
PHST- 2022/03/14 05:15 [entrez]
PHST- 2022/03/15 06:00 [pubmed]
PHST- 2022/03/15 06:01 [medline]
PHST- 2022/02/25 00:00 [pmc-release]
AID - 10.3389/fmed.2022.754116 [doi]
PST - epublish
SO  - Front Med (Lausanne). 2022 Feb 25;9:754116. doi: 10.3389/fmed.2022.754116. 
      eCollection 2022.