Efficacy and safety of Janus kinase inhibitors in the treatment of psoriasis and psoriatic arthritis: An analysis of evidence from 2014 to 2022
Background: The efficacy and safety of Janus kinase (JAK) inhibitors as novel therapeutic agents for psoriasis (PSO) and psoriatic arthritis (PsA) have not yet been systematically evaluated. Methods: Randomized controlled studies (RCTs) assessing JAK inhibitors to treat PSO or PsA published before S...
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Elsevier
2025-02-01
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| author | Jiao Wang Tian Ma Xiaoying Sun Liu Liu Seokgyeong Hong Huijung Cha Miao Zhang Jiale Chen Naixuan Lin Bin Li Xin Li |
| author_facet | Jiao Wang Tian Ma Xiaoying Sun Liu Liu Seokgyeong Hong Huijung Cha Miao Zhang Jiale Chen Naixuan Lin Bin Li Xin Li |
| author_sort | Jiao Wang |
| collection | DOAJ |
| description | Background: The efficacy and safety of Janus kinase (JAK) inhibitors as novel therapeutic agents for psoriasis (PSO) and psoriatic arthritis (PsA) have not yet been systematically evaluated. Methods: Randomized controlled studies (RCTs) assessing JAK inhibitors to treat PSO or PsA published before September 1, 2022, were searched in the PubMed, Embase, and Cochrane Library databases. The Psoriasis Area and Severity Index (PASI) 75 and American College of Rheumatology (ACR) 50 were established as primary outcome indicators of PSO and PsA, respectively. Adverse events (AEs) were classified according to eight systems of the human body. Results: We included 16 relevant RCTs involving 4,936 patients with psoriasis, with interventions performed using different doses of JAK inhibitors. Except in one study, all patients received a placebo or vehicle control. JAK inhibitors were administered topically in three studies and orally administered in the remaining studies. Meta-analysis revealed that oral administration of JAK inhibitors significantly improved PASI 75 in patients with PSO (risk ratio [RR] 3.29; 95 % confidence interval [CI] [2.37, 4.57]), and topical application was not effective (RR 1.45, 95 % CI [0.97, 2.15]). JAK1 and JAK3 inhibitors were more effective than JAK1/JAK 2 inhibitors for PASI 75. JAK1 inhibitors elicited high response rates in improving ACR 50 in PsA (RR 2.95, 95 % CI [1.63, 5.35]) and achieved significant results at week 16 of treatment (RR 2.95, 95 % CI [1.63, 5.35]). Oral JAK inhibitor-induced AEs were mainly related to the circulatory system (RR 3.09, 95 % CI [1.42, 6.75]). Conclusions: Oral JAK inhibitors improved clinical symptoms in patients with PSO. Tofacitinib, a JAK1 and JAK3 inhibitor, has a high response rate. Filgotinib, a JAK1 inhibitor, markedly enhanced the response rate and improved ACR scores in patients with PsA, and the best effect was achieved with 16-week oral administration. |
| format | Article |
| id | doaj-art-e175742959fc4378b8d664c2571faffb |
| institution | Kabale University |
| issn | 2405-8440 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
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| spelling | doaj-art-e175742959fc4378b8d664c2571faffb2025-02-07T04:47:54ZengElsevierHeliyon2405-84402025-02-01113e42084Efficacy and safety of Janus kinase inhibitors in the treatment of psoriasis and psoriatic arthritis: An analysis of evidence from 2014 to 2022Jiao Wang0Tian Ma1Xiaoying Sun2Liu Liu3Seokgyeong Hong4Huijung Cha5Miao Zhang6Jiale Chen7Naixuan Lin8Bin Li9Xin Li10Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, ChinaDepartment of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, ChinaInstitute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, ChinaDepartment of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, ChinaInstitute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, ChinaDepartment of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, ChinaDepartment of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, ChinaDepartment of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, ChinaDepartment of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, ChinaInstitute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China; Department of Dermatology, Shanghai Skin Disease Hospital, Shanghai, 200443, ChinaDepartment of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China; Corresponding author. Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China.Background: The efficacy and safety of Janus kinase (JAK) inhibitors as novel therapeutic agents for psoriasis (PSO) and psoriatic arthritis (PsA) have not yet been systematically evaluated. Methods: Randomized controlled studies (RCTs) assessing JAK inhibitors to treat PSO or PsA published before September 1, 2022, were searched in the PubMed, Embase, and Cochrane Library databases. The Psoriasis Area and Severity Index (PASI) 75 and American College of Rheumatology (ACR) 50 were established as primary outcome indicators of PSO and PsA, respectively. Adverse events (AEs) were classified according to eight systems of the human body. Results: We included 16 relevant RCTs involving 4,936 patients with psoriasis, with interventions performed using different doses of JAK inhibitors. Except in one study, all patients received a placebo or vehicle control. JAK inhibitors were administered topically in three studies and orally administered in the remaining studies. Meta-analysis revealed that oral administration of JAK inhibitors significantly improved PASI 75 in patients with PSO (risk ratio [RR] 3.29; 95 % confidence interval [CI] [2.37, 4.57]), and topical application was not effective (RR 1.45, 95 % CI [0.97, 2.15]). JAK1 and JAK3 inhibitors were more effective than JAK1/JAK 2 inhibitors for PASI 75. JAK1 inhibitors elicited high response rates in improving ACR 50 in PsA (RR 2.95, 95 % CI [1.63, 5.35]) and achieved significant results at week 16 of treatment (RR 2.95, 95 % CI [1.63, 5.35]). Oral JAK inhibitor-induced AEs were mainly related to the circulatory system (RR 3.09, 95 % CI [1.42, 6.75]). Conclusions: Oral JAK inhibitors improved clinical symptoms in patients with PSO. Tofacitinib, a JAK1 and JAK3 inhibitor, has a high response rate. Filgotinib, a JAK1 inhibitor, markedly enhanced the response rate and improved ACR scores in patients with PsA, and the best effect was achieved with 16-week oral administration.http://www.sciencedirect.com/science/article/pii/S2405844025004645Janus kinase (JAK) inhibitorsPsoriasis (PSO)Psoriatic arthritis (PsA)Randomized controlled studyMeta-analysis |
| spellingShingle | Jiao Wang Tian Ma Xiaoying Sun Liu Liu Seokgyeong Hong Huijung Cha Miao Zhang Jiale Chen Naixuan Lin Bin Li Xin Li Efficacy and safety of Janus kinase inhibitors in the treatment of psoriasis and psoriatic arthritis: An analysis of evidence from 2014 to 2022 Heliyon Janus kinase (JAK) inhibitors Psoriasis (PSO) Psoriatic arthritis (PsA) Randomized controlled study Meta-analysis |
| title | Efficacy and safety of Janus kinase inhibitors in the treatment of psoriasis and psoriatic arthritis: An analysis of evidence from 2014 to 2022 |
| title_full | Efficacy and safety of Janus kinase inhibitors in the treatment of psoriasis and psoriatic arthritis: An analysis of evidence from 2014 to 2022 |
| title_fullStr | Efficacy and safety of Janus kinase inhibitors in the treatment of psoriasis and psoriatic arthritis: An analysis of evidence from 2014 to 2022 |
| title_full_unstemmed | Efficacy and safety of Janus kinase inhibitors in the treatment of psoriasis and psoriatic arthritis: An analysis of evidence from 2014 to 2022 |
| title_short | Efficacy and safety of Janus kinase inhibitors in the treatment of psoriasis and psoriatic arthritis: An analysis of evidence from 2014 to 2022 |
| title_sort | efficacy and safety of janus kinase inhibitors in the treatment of psoriasis and psoriatic arthritis an analysis of evidence from 2014 to 2022 |
| topic | Janus kinase (JAK) inhibitors Psoriasis (PSO) Psoriatic arthritis (PsA) Randomized controlled study Meta-analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2405844025004645 |
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