Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.
Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Acta Derm Venereol. 2023 Jan 25;103:adv00855. doi: 10.2340/actadv.v103.4536.
The aim of this study was to compare the efficacy and safety of treatment with Janus kinase inhibitors for alopecia areata, measured by change in Severity of Alopecia Tool (SALT) score. A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines was performed using Medline, EMBASE and Cochrane library. All studies investigating the efficacy of treatments for alopecia areata were included. Primary outcomes were the proportion of patients with alopecia areata achieving 30%, 50%, 75%, 90% and 100% improvement in SALT score after treatment with a Janus kinase inhibitor. A meta-analysis was performed including all randomized controlled trials investigating Janus kinase inhibitors. A total of 37 studies matched the inclusion criteria and were included. Meta-analysis was performed based on 5 randomized studies. Regarding patients with alopecia areata defined as ≥ 50% scalp hair loss, baricitinib 4 mg once daily demonstrated the highest efficacy. However, among patients with alopecia areata defined as a SALT score ≥ 50, oral deuruxolitinib 12 mg twice daily demonstrated the highest efficacy. Deuruxolitinib and baricitinib appear to be promising drugs for the treatment of alopecia areata. However, the response depends on the dosage of the drug. More randomized trials, with identical inclusion criteria and dose and duration of treatment, are required to confirm these findings.
本研究旨在比较 Janus 激酶抑制剂治疗斑秃的疗效和安全性，通过严重程度脱发工具（SALT）评分的变化来衡量。根据系统评价和荟萃分析的首选报告项目（PRISMA）指南，使用 Medline、EMBASE 和 Cochrane 图书馆进行了系统评价。纳入了所有研究斑秃治疗效果的研究。主要结局是接受 Janus 激酶抑制剂治疗后，SALT 评分达到 30%、50%、75%、90%和 100%改善的斑秃患者比例。对所有研究 Janus 激酶抑制剂的随机对照试验进行了荟萃分析。共有 37 项研究符合纳入标准并被纳入。基于 5 项随机研究进行了荟萃分析。对于定义为≥50%头皮脱发的斑秃患者，巴瑞替尼 4 毫克每日一次显示出最高的疗效。然而，对于 SALT 评分≥50 的斑秃患者，口服杜鲁替尼 12 毫克每日两次显示出最高的疗效。杜鲁替尼和巴瑞替尼似乎是治疗斑秃有前途的药物。然而，反应取决于药物的剂量。需要更多具有相同纳入标准和治疗剂量及持续时间的随机试验来证实这些发现。
