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使用口服 Janus 激酶抑制剂导致体重增加:一项系统评价和荟萃分析。

Weight gain secondary to the use of oral Janus kinase inhibitors: A systematic review and meta-analysis.

作者信息

Xiong Grace, Yu Eric, Heung Martin, Yang Jaehyeong, Lowe Megan, Abu-Hilal Mohannad

机构信息

Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Canada.

Faculty of Health Sciences, McMaster University, Hamilton, Canada.

出版信息

JAAD Int. 2024 Dec 19;19:1-9. doi: 10.1016/j.jdin.2024.11.009. eCollection 2025 Apr.

Abstract

Oral Janus kinase inhibitors (JAKi) are increasingly used in dermatology, rheumatology, gastroenterology, and hematology. While effective, they can cause adverse effects such as acne, nausea, cytopenia, dyslipidemia, and Herpes zoster. Recent reports have linked JAKi usage to weight changes, particularly weight gain, which can significantly impact patients' quality of life. This study aimed to describe the incidence and characteristics of weight changes associated with the use of JAKi. Ovid MEDLINE, Embase, Web of Science, and Clinicaltrials.gov were searched up to April 2024. From 1080 initial articles, 90 studies covering 16,000 patients were selected. Our analysis found a notable incidence of weight gain with JAKi usage. Overall, 5.9% (947/16,000) of patients reported weight again. In randomized control trials, weight gain was observed in 7% (95% CI: 0.04; 0.09) of patients, while weight loss was observed in 1% (95% CI: 0.00; 0.03). Patients with dermatologic indications had lower weight gain rates (4%, 95% CI: 0.01; 0.06) than those with nondermatological indications (7%, 95% CI: 0.04; 0.10). Overall, JAKi therapy is associated with weight changes, particularly weight gain, underscoring the importance of appropriate counseling and weight monitoring. Further long-term studies are needed to better understand the mechanisms and management of JAKi-related weight changes.

摘要

口服 Janus 激酶抑制剂(JAKi)在皮肤科、风湿病学、胃肠病学和血液学中的应用越来越广泛。虽然它们有效,但可能会引起不良反应,如痤疮、恶心、血细胞减少、血脂异常和带状疱疹。最近的报告将 JAKi 的使用与体重变化联系起来,尤其是体重增加,这可能会对患者的生活质量产生重大影响。本研究旨在描述与 JAKi 使用相关的体重变化的发生率和特征。检索了截至 2024 年 4 月的 Ovid MEDLINE、Embase、Web of Science 和 Clinicaltrials.gov。从 1080 篇初始文章中,筛选出 90 项涵盖 16000 名患者的研究。我们的分析发现,使用 JAKi 后体重增加的发生率显著。总体而言,5.9%(947/16000)的患者报告体重增加。在随机对照试验中,7%(95%CI:0.04;0.09)的患者体重增加,而 1%(95%CI:0.00;0.03)的患者体重减轻。有皮肤病适应症的患者体重增加率(4%,95%CI:0.01;0.06)低于无皮肤病适应症的患者(7%,95%CI:0.04;0.10)。总体而言,JAKi 治疗与体重变化相关,尤其是体重增加,这凸显了适当咨询和体重监测的重要性。需要进一步的长期研究来更好地了解 JAKi 相关体重变化的机制和管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e310/11763511/8d858b5a02ca/gr1.jpg

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