Department of Rheumatology, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
Department of Rheumatology, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
Eur J Intern Med. 2022 Aug;102:47-53. doi: 10.1016/j.ejim.2022.04.007. Epub 2022 Apr 20.
To assess the efficacy and safety of janus kinase (JAK) inhibitors in the treatment of ankylosing spondylitis (AS).
We searched the PubMed and Cochrane Central Register of Controlled Trials to Nov 1, 2021. We included all randomized controlled trials (RCTs) evaluating JAK inhibitors in the treatment of AS. Two reviewers independently selected studies, extracted data and assessed the risk of bias.
Four RCT studies with 779 participants were included in the meta-analysis. Compared with placebo group, percentages of participants achieving responses of Assessment of spondyloarthritis international society(ASAS) 20, ASAS 40, ASAS 5/6, Bath AS disease activity index (BASDAI) 50 were significantly higher in JAK inhibitor group respectively; changes from baseline in AS disease activity score using C-reactive protein(ASDAS-CRP), Maastricht AS enthesitis score (MASES), AS Quality of Life (ASQoL) score, short-form-36 health survey physical component summary (SF-36 PCS) score, BASDAI, Bath AS functional index (BASFI), Bath AS metrology index (BASMI), Functional Assessment of Chronic Illness Therapy-fatigue (FACIT-F) score, SPARCC joint score and Work Productivity and Activity Impairment (WPAI) Overall Work Impairment score showed significant improvements in JAK inhibitor group. The incidence of adverse events (AEs) and severe adverse events (SAEs) showed no significant differences between the JAK inhibitor and placebo groups.
JAK inhibitors showed a satisfactory and promising efficacy in the treatment of active AS not only in mitigating disease activity, but also substantially improving patient's physical function, emotional well-being and social participation. The results of this meta-analysis provide solid evidence for JAK inhibitor as a novel therapeutic strategy for patients with active AS.
评估 Janus 激酶（JAK）抑制剂治疗强直性脊柱炎（AS）的疗效和安全性。
我们检索了 PubMed 和 Cochrane 中央对照试验注册库，截至 2021 年 11 月 1 日。我们纳入了所有评估 JAK 抑制剂治疗 AS 的随机对照试验（RCT）。两名审查员独立选择研究、提取数据并评估偏倚风险。
纳入了 4 项 RCT 研究，共 779 名参与者进行了荟萃分析。与安慰剂组相比，JAK 抑制剂组分别有更高比例的参与者达到以下终点：评估强直性脊柱炎国际协会（ASAS）20、ASAS 40、ASAS 5/6、Bath AS 疾病活动指数（BASDAI）50 的应答者；使用 C 反应蛋白（ASDAS-CRP）、马斯特里赫特 AS 附着点炎评分（MASES）、AS 生活质量（ASQoL）评分、短式 36 健康调查生理成分综合评分（SF-36 PCS）评分、BASDAI、Bath AS 功能指数（BASFI）、Bath AS 计量指数（BASMI）、慢性疾病治疗疲劳量表（FACIT-F）评分、SPARCC 关节评分和工作效率和活动障碍（WPAI）整体工作障碍评分的疾病活动评分自基线的变化均有显著改善。JAK 抑制剂组和安慰剂组的不良反应（AE）和严重不良事件（SAE）发生率无显著差异。
JAK 抑制剂在治疗活动期 AS 方面显示出令人满意和有前途的疗效，不仅能减轻疾病活动度，还能显著改善患者的身体功能、情绪健康和社会参与度。本荟萃分析的结果为 JAK 抑制剂作为一种新型治疗策略，为活动期 AS 患者提供了有力证据。
