Kim Yunha, Seo Gayeong, Koopman Jacob J E, Yee Jeong
School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea.
Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Clin Exp Allergy. 2025 Sep;55(9):755-772. doi: 10.1111/cea.70125. Epub 2025 Aug 2.
The aim of this study is to evaluate the effectiveness and safety of JAK inhibitors in patients with moderate to severe atopic dermatitis by performing a systematic review and meta-analysis using data from studies in real-world settings.
Systematic review and meta-analysis. Pooled estimates for effectiveness and safety were assessed using the Freeman-Tukey Double ArcSine method. Statistical heterogeneity was assessed using I statistics. A random-effects model (DerSimonian-Laird method) was applied to consider the heterogeneity within and between studies and to give a more conservative estimate. The study quality assessment tools developed by the National Heart, Lung, and Blood Institute were used.
Relevant studies were searched in March 2025 using four databases: PubMed, Embase, Scopus, and Web of Science.
Studies evaluating the effectiveness or safety of systemic JAK inhibitors among patients with moderate to severe atopic dermatitis in a real-world setting were included.
A total of 50 studies were included in this review. Regarding their effectiveness, the pooled estimates with a 95% CI of Eczema Area and Severity Index (EASI)-75 were 44% (34%-55%), 45% (28%-62%), 59% (51%-66%), 73% (64%-81%), 70% (57%-81%), and 86% (72%-96%) at 4, 8, 12, 16, 24, and 52 weeks. For safety, the most common adverse events were acne (16%), followed by increased creatine phosphokinase levels (13%) and increased lipids (12%).
Our meta-analysis of JAK inhibitors in patients with atopic dermatitis demonstrated that the overall outcomes from real-world settings are comparable to those from clinical trials.
Protocol Registration: PROSPERO CRD42024569258.
本研究旨在通过对来自真实世界研究的数据进行系统评价和荟萃分析，评估JAK抑制剂在中度至重度特应性皮炎患者中的有效性和安全性。
系统评价和荟萃分析。使用弗里曼-图基双反正弦方法评估有效性和安全性的合并估计值。使用I统计量评估统计异质性。应用随机效应模型（DerSimonian-Laird方法）来考虑研究内部和研究之间的异质性，并给出更保守的估计。使用美国国立心肺血液研究所开发的研究质量评估工具。
2025年3月使用四个数据库（PubMed、Embase、Scopus和Web of Science）检索相关研究。
纳入在真实世界环境中评估全身JAK抑制剂在中度至重度特应性皮炎患者中的有效性或安全性的研究。
本评价共纳入50项研究。关于其有效性，在4、8、12、16、24和52周时，湿疹面积和严重程度指数（EASI）改善75%的合并估计值（95%CI）分别为44%（34%-55%）、45%（28%-62%）、59%（51%-66%）、73%（64%-81%）、70%（57%-81%）和86%（72%-96%）。在安全性方面，最常见的不良事件是痤疮（16%），其次是肌酸磷酸激酶水平升高（13%）和血脂升高（12%）。
我们对特应性皮炎患者使用JAK抑制剂的荟萃分析表明，真实世界环境中的总体结果与临床试验中的结果相当。
方案注册号：PROSPERO CRD42024569258 。
