Montilla Ana M, Gómez-García Francisco, Gómez-Arias Pedro J, Gay-Mimbrera Jesús, Hernández-Parada Jorge, Isla-Tejera Beatriz, Ruano Juan
Immune-mediated Inflammatory Skin Diseases Group, IMIBIC/Reina Sofía University Hospital/University of Córdoba, 14004, Córdoba, Spain.
School of Medicine, University of Córdoba, 14004, Córdoba, Spain.
Dermatol Ther (Heidelb). 2019 Dec;9(4):655-683. doi: 10.1007/s13555-019-00329-y. Epub 2019 Oct 13.
The JAK/STAT signaling pathway is involved in the immune-mediated inflammatory skin diseases atopic dermatitis (AD), vitiligo, and alopecia areata (AA), and represents a potential target when developing treatments. So far, no drugs targeting this pathway have been approved for the treatment of dermatological diseases. We reviewed the use of drugs blocking the JAK/STAT pathway in the aforementioned diseases.
An a priori protocol was published. We used Joanna Briggs Institute Reviewer's Manual methodology to conduct the review and PRISMA Extension for Scoping Review (PRISMA-ScR) to report results. MEDLINE, EMBASE, CINAHL, Scopus, and Web of Science databases were searched in a three-step approach on April 2019 by two researchers.
Ninety-six mainly multicenter observational studies were included (66, 10, and 20 studies on AA, vitiligo, and AD, respectively). Tofacitinib and ruxolitinib were mainly used for the three diseases, and also upadacitinib, abrocitinib, baricitinib, cerdulatinib, delgocitinib, gusacitinib for AD, and baricitinib, PF-06700841, and PF-06651600 for AA. All patients with AD improved, whereas patients with vitiligo and patients with AA showed varied responses, including unresponsive cases. The safety profiles were similar for all drugs and diseases, mainly comprising mild or no adverse events.
Evidence on the efficacy and safety of drugs targeting the JAK/STAT pathway for the treatment of patients with AD, vitiligo, or AA is increasing but is still of low quality.
JAK/STAT信号通路参与免疫介导的炎症性皮肤病，如特应性皮炎（AD）、白癜风和斑秃（AA），是开发治疗方法时的一个潜在靶点。到目前为止，尚无靶向该通路的药物被批准用于治疗皮肤病。我们综述了阻断JAK/STAT通路的药物在上述疾病中的应用。
已发表了一个预先制定的方案。我们采用乔安娜·布里格斯研究所评审手册方法进行综述，并使用系统综述扩展版的PRISMA（PRISMA-ScR）报告结果。2019年4月，两名研究人员分三步检索了MEDLINE、EMBASE、CINAHL、Scopus和Web of Science数据库。
纳入了96项主要为多中心的观察性研究（分别有66项、10项和20项关于斑秃、白癜风和特应性皮炎的研究）。托法替布和芦可替尼主要用于这三种疾病，此外，乌帕替尼、阿布昔替尼、巴瑞替尼、塞度替尼、德谷替尼、古塞替尼用于特应性皮炎，巴瑞替尼、PF-06700841和PF-06651600用于斑秃。所有特应性皮炎患者均有改善，而白癜风患者和斑秃患者的反应各不相同，包括无反应病例。所有药物和疾病的安全性概况相似，主要包括轻度或无不良事件。
靶向JAK/STAT通路的药物治疗特应性皮炎、白癜风或斑秃患者的疗效和安全性证据正在增加，但质量仍然较低。
