Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Front Immunol. 2023 Jun 2;14:1195858. doi: 10.3389/fimmu.2023.1195858. eCollection 2023.
JAK inhibitors treat various autoimmune diseases, but an updated systematic review in treating alopecia areata is currently lacking.
Evaluate the specific efficacy and safety of JAK inhibitors in alopecia areata by systematic review and meta-analysis.
Eligible studies in PubMed, Embase, Web of Science, and Clinical Trials up to May 30, 2022, were searched. We enrolled in randomized controlled trials and observational studies of applying JAK inhibitors in alopecia areata.
6 randomized controlled trials with 1455 patients exhibited SALT (odd ratio [OR], 5.08; 95% confidence interval [CI], 3.49-7.38), SALT (OR, 7.40; 95% CI, 4.34-12.67) and change in SALT score (weighted mean difference [WSD], 5.55; 95% CI, 2.60-8.50) compared to the placebo. The proportion of 26 observational studies with 563 patients of SALT was 0.71(95% CI, 0.65-0.78), SALT was 0.54(95% CI 0.46-0.63), SALT was 0.33(95% CI, 0.24-0.42), and SALT score (WSD, -2.18; 95% CI, -3.12 to -1.23) compared with baseline. Any adverse effects occurred in 921 of 1508 patients; a total of 30 patients discontinued the trial owing to adverse reactions.
Few randomized controlled trials met the inclusion criteria and insufficiency of eligible data.
JAK inhibitors are effective in alopecia areata, although associated with an increased risk.
JAK 抑制剂可治疗多种自身免疫性疾病，但目前缺乏关于治疗斑秃的最新系统评价。
通过系统评价和荟萃分析评估 JAK 抑制剂治疗斑秃的具体疗效和安全性。
检索截至 2022 年 5 月 30 日PubMed、Embase、Web of Science 和临床试验数据库中关于 JAK 抑制剂治疗斑秃的随机对照试验和观察性研究。
纳入的 6 项随机对照试验共 1455 例患者显示 SALT（比值比[OR]，5.08；95%置信区间[CI]，3.49-7.38）、SALT（OR，7.40；95%CI，4.34-12.67）和 SALT 评分变化（加权均数差[WSD]，5.55；95%CI，2.60-8.50）均优于安慰剂。26 项观察性研究共纳入 563 例患者，SALT 比例为 0.71（95%CI，0.65-0.78）、SALT 为 0.54（95%CI，0.46-0.63）、SALT 为 0.33（95%CI，0.24-0.42）和 SALT 评分（WSD，-2.18；95%CI，-3.12 至-1.23）均较基线下降。在 1508 例患者中，有 921 例发生任何不良反应；共有 30 例患者因不良反应而退出试验。
符合纳入标准的随机对照试验较少，且合格数据不足。
JAK 抑制剂治疗斑秃有效，但相关不良反应风险增加。
