Department of Anesthesiology and Intensive Care, Universitas Indonesia - Rumah Sakit Cipto Mangunkusumo, Jakarta, Indonesia.
Faculty of Medicine, Pelita Harapan University, Tangerang, Indonesia.
Expert Rev Anti Infect Ther. 2022 Mar;20(3):425-434. doi: 10.1080/14787210.2021.1982695. Epub 2021 Sep 29.
BACKGROUND: Currently, JAK-inhibitors are repurposed for therapy of Covid-19 because of their ability in restraining immune response, yet the corroboration regarding their advantage is still unclear. This study sought to analyze the efficacy of JAK-inhibitors to ameliorate the outcomes of Covid-19 sufferer. Using specific keywords, we comprehensively go through the potential articles on ClinicalTrials.gov, Europe PMC, and PubMed sources until June 2, 2021. All published studies on JAK-inhibitors and Covid-19 were collected. RESULTS: There were 14 studies with 4,363 Covid-19 patients contained in the meta-analysis. Based on our data, we suggested that JAK-inhibitors corresponded with increased recovery rate (RR 1.17; 95%CI: 1.01-1.36, = 0.040, = 91%, random-effect modeling); shortened time to recovery (mean difference -0.96; 95%CI: -1.15, -0.77, < 0.00001, = 28%, random-effect modeling); reduction of clinical deterioration risk (RR 0.66; 95%CI: 0.48-0.89, = 0.008, = 57%, random-effect modeling); and reduction of Covid-19 mortality (RR 0.52; 95%CI: 0.36-0.76, = 0.0006, = 33%, random-effect modeling). CONCLUSIONS: This study propose that JAK-inhibitors perhaps provide advantageous effects on Covid-19 outcomes. JAK-inhibitors may be given during 1-2 weeks of disease to optimize its beneficial effects in halting the exaggerated immune response.
背景:目前,由于 JAK 抑制剂能够抑制免疫反应,因此被重新用于治疗 COVID-19,但关于其优势的证据仍不清楚。本研究旨在分析 JAK 抑制剂改善 COVID-19 患者结局的疗效。我们使用特定的关键词,全面检索了 ClinicalTrials.gov、Europe PMC 和 PubMed 数据库中截至 2021 年 6 月 2 日的潜在文章。收集了所有关于 JAK 抑制剂和 COVID-19 的已发表研究。
结果:共有 14 项研究纳入了 4363 例 COVID-19 患者的 meta 分析。根据我们的数据,我们认为 JAK 抑制剂与更高的恢复率相关(RR 1.17;95%CI:1.01-1.36,=0.040,=91%,随机效应模型);缩短恢复时间(均数差-0.96;95%CI:-1.15,-0.77,<0.00001,=28%,随机效应模型);降低临床恶化风险(RR 0.66;95%CI:0.48-0.89,=0.008,=57%,随机效应模型);降低 COVID-19 死亡率(RR 0.52;95%CI:0.36-0.76,=0.0006,=33%,随机效应模型)。
结论:本研究表明 JAK 抑制剂可能对 COVID-19 结局具有有益的影响。JAK 抑制剂可能在疾病的 1-2 周内使用,以优化其抑制过度免疫反应的有益作用。
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