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Janus 激酶(JAK)抑制剂与 2019 年冠状病毒病(COVID-19)结局:系统评价和荟萃分析。

Janus kinase (JAK)-inhibitors and coronavirus disease 2019 (Covid-19) outcomes: a systematic review and meta-analysis.

机构信息

Department of Anesthesiology and Intensive Care, Universitas Indonesia - Rumah Sakit Cipto Mangunkusumo, Jakarta, Indonesia.

Faculty of Medicine, Pelita Harapan University, Tangerang, Indonesia.

出版信息

Expert Rev Anti Infect Ther. 2022 Mar;20(3):425-434. doi: 10.1080/14787210.2021.1982695. Epub 2021 Sep 29.


DOI:10.1080/14787210.2021.1982695
PMID:34538216
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8500309/
Abstract

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.

摘要

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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本文引用的文献

[1]
Ruxolitinib versus dexamethasone in hospitalized adults with COVID-19: multicenter matched cohort study.

BMC Infect Dis. 2021-12-22

[2]
Efficacy and safety of baricitinib for the treatment of hospitalised adults with COVID-19 (COV-BARRIER): a randomised, double-blind, parallel-group, placebo-controlled phase 3 trial.

Lancet Respir Med. 2021-12

[3]
Pre-admission glucagon-like peptide-1 receptor agonist (GLP-1RA) and mortality from coronavirus disease 2019 (Covid-19): A systematic review, meta-analysis, and meta-regression.

Diabetes Res Clin Pract. 2021-9

[4]
Janus Kinase Inhibitors and Coronavirus Disease (COVID)-19: Rationale, Clinical Evidence and Safety Issues.

Pharmaceuticals (Basel). 2021-7-28

[5]
Tofacitinib reduces mortality in coronavirus disease 2019 Tofacitinib in COVID-19.

Pulm Pharmacol Ther. 2021-8

[6]
Human immunodeficiency virus and mortality from coronavirus disease 2019: A systematic review and meta-analysis.

South Afr J HIV Med. 2021-4-15

[7]
Parkinson's disease may worsen outcomes from coronavirus disease 2019 (COVID-19) pneumonia in hospitalized patients: A systematic review, meta-analysis, and meta-regression.

Parkinsonism Relat Disord. 2021-6

[8]
Obstructive sleep apnea (OSA) and outcomes from coronavirus disease 2019 (COVID-19) pneumonia: a systematic review and meta-analysis.

Sleep Med. 2021-6

[9]
Colchicine treatment can improve outcomes of coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis.

Clin Exp Pharmacol Physiol. 2021-6

[10]
Janus kinase signaling as risk factor and therapeutic target for severe SARS-CoV-2 infection.

Eur J Immunol. 2021-5

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