PMID- 37013725
OWN - NLM
STAT- Publisher
LR  - 20230418
IS  - 1468-3083 (Electronic)
IS  - 0926-9959 (Linking)
DP  - 2023 Apr 4
TI  - Adverse events in patients treated with Jak-inhibitors for alopecia areata: A 
      systematic review.
LID - 10.1111/jdv.19090 [doi]
AB  - Recently, the impressive efficacy of JAK-inhibitors (JAK-I) in alopecia areata 
      (AA) has been described in several studies; however, to date, there is limited 
      information on the safety of JAK-I in AA patients. For this reason, on 18 August 
      2022, a systematic review was performed to collect the premarketing and 
      postmarketing data on the safety of JAK-I in patients treated for AA, evaluating 
      for each molecule the reported adverse events (AEs) in indexed literature and 
      their frequency. The keywords 'alopecia areata' AND 'Jak-inhibitors OR 
      Janus-kinase Inhibitors' were searched on PubMed, Embase and Cochrane databases. 
      Of 407 studies retrieved, 28 papers met the requirements and were used in our 
      review, including five RCTs and 23 case series; overall, 1719 patients were 
      included, and the safety of 6 JAK-I was assessed (baricitinib, brepocitinib, 
      deuruxolitinib, ritlecitinib, ruxolitinib and tofacitinib). Systemic JAK-I were 
      well-tolerated, most of the AEs were mild, and the withdrawal rate for AEs was 
      very low and inferior to placebo in controlled studies (1.6% vs. 2.2%). 
      Laboratory abnormalities represented 40.1% of AEs associated with oral JAK-I, 
      which mostly included the rise in cholesterol, transaminase, triglycerides, 
      creatine phosphokinase (CPK) and sporadic cases of neutro/lymphocytopenia. The 
      remaining AEs involved the respiratory tract (20.8%), the skin (17.2%), the 
      urogenital (3.8%), or the gastroenterological (3.4%) tract. Increased rates of 
      infections involved not only the upper (19.0%) and lower (0.3%) respiratory 
      tract, but also the urogenital system (3.6%) and the skin (4.6%). Isolated cases 
      of grade 3 to 4 AEs have been reported, including myocardial infarction, 
      hypertensive urgencies, cellulitis, rhabdomyolysis, neutropenia and high 
      elevation of creatinine kinase. No fatal outcomes were reported. AEs reported 
      with topical formulation included scalp irritation and folliculitis. The main 
      limit of this review is the lack of data related to postmarketing surveillance, 
      which should be maintained on a long-term basis.
CI  - (c) 2023 The Authors. Journal of the European Academy of Dermatology and 
      Venereology published by John Wiley & Sons Ltd on behalf of European Academy of 
      Dermatology and Venereology.
FAU - Sechi, Andrea
AU  - Sechi A
AUID- ORCID: 0000-0003-3026-2434
AD  - Dermatology Unit, San Bortolo Hospital, Vicenza, Italy.
AD  - Division of Dermatology, Department of Experimental, Diagnostic and Specialty 
      Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico 
      S'Orsola, Bologna, Italy.
FAU - Song, Junhyuk
AU  - Song J
AUID- ORCID: 0000-0003-4655-2030
AD  - Dermatology Unit, San Bortolo Hospital, Vicenza, Italy.
AD  - Faculty of Medicine and Surgery, Department of Medicine DIMED, University of 
      Padua, Padova, Italy.
FAU - Dell'Antonia, Massimo
AU  - Dell'Antonia M
AUID- ORCID: 0000-0003-0250-5750
AD  - Dermatology Clinic, Department of Medical Sciences and Public Health, University 
      of Cagliari, Cagliari, Italy.
FAU - Heidemeyer, Kristine
AU  - Heidemeyer K
AUID- ORCID: 0000-0001-9217-6086
AD  - Dermatology Unit, San Bortolo Hospital, Vicenza, Italy.
AD  - Department of Dermatology, Bern University Hospital Clinic for Dermatology, 
      Inselspital, Bern, Switzerland.
FAU - Piraccini, Bianca Maria
AU  - Piraccini BM
AUID- ORCID: 0000-0001-6537-9689
AD  - Division of Dermatology, Department of Experimental, Diagnostic and Specialty 
      Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico 
      S'Orsola, Bologna, Italy.
FAU - Starace, Michela
AU  - Starace M
AUID- ORCID: 0000-0002-3981-1527
AD  - Division of Dermatology, Department of Experimental, Diagnostic and Specialty 
      Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico 
      S'Orsola, Bologna, Italy.
FAU - Naldi, Luigi
AU  - Naldi L
AD  - Dermatology Unit, San Bortolo Hospital, Vicenza, Italy.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230404
PL  - England
TA  - J Eur Acad Dermatol Venereol
JT  - Journal of the European Academy of Dermatology and Venereology : JEADV
JID - 9216037
SB  - IM
EDAT- 2023/04/05 06:00
MHDA- 2023/04/05 06:00
CRDT- 2023/04/04 04:23
PHST- 2022/09/30 00:00 [received]
PHST- 2023/03/21 00:00 [accepted]
PHST- 2023/04/05 06:00 [pubmed]
PHST- 2023/04/05 06:00 [medline]
PHST- 2023/04/04 04:23 [entrez]
AID - 10.1111/jdv.19090 [doi]
PST - aheadofprint
SO  - J Eur Acad Dermatol Venereol. 2023 Apr 4. doi: 10.1111/jdv.19090.