- 2023-12
- Autoimmunity reviews 22(12)
- Leyao Ma
- Liying Peng
- Jiuliang Zhao
- Wei Bai
- Nan Jiang
- Shangzhu Zhang
- Chanyuan Wu
- Li Wang
- Dong Xu
- Xiaomei Leng
- Qian Wang
- Wen Zhang
- Yan Zhao
- Xinping Tian
- Mengtao Li
- Xiaofeng Zeng
Study Design
- Type
- Meta-Analysis
- Sample size
- n = 460
- Population
- systemic and cutaneous lupus erythematosus patients
- Methods
- Systematic review and meta-analysis of studies up to February 28, 2023, searching PubMed, Embase, Web of Science, and Cochrane Library; Cochrane risk-of-bias tool; meta-analysis with at least three studies for comparable outcomes
Background
Janus kinase (JAK) inhibitors have been proven to be effective and safe in various autoimmune diseases. However, there is still a lack of comprehensive evidence regarding their efficacy and safety in systemic and cutaneous lupus erythematosus.Methods
We searched for systemic and cutaneous lupus erythematosus patients who were treated with JAK inhibitors in PubMed, Embase, Web of Science, and the Cochrane Library until February 28, 2023. The quality of clinical trials was assessed using the Cochrane risk-of-bias tool. Meta-analysis was conducted when at least three studies had comparable measures of outcome. If meta-analysis was not feasible, a descriptive review was carried out.Results
We included 30 studies, consisting of 10 randomized controlled trials and 20 case series or reports, with a total of 2,460 patients. JAK inhibitors were found to be more effective than placebo in systemic lupus erythematosus (SLE) based on the percentage of achieving SLE Responder Index (SRI)-4 response (RR = 1.18; 95% CI 1.07 to 1.31; p = 0.001), British Isles Lupus Assessment Group -based Composite Lupus Assessment (BICLA) response (RR = 1.16; 95% CI 1.02 to 1.31; p = 0.02), Lupus Low Disease Activity State (LLDAS) (RR = 1.28; 95% CI 1.07 to 1.54; p = 0.008), and Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2 K) remission of arthritis or rash (RR = 1.09; 95% CI 1.00 to 1.18; p = 0.04), particularly in treating musculoskeletal and mucocutaneous involvement. However, the effect of JAK inhibitors on cutaneous lupus erythematosus was uncertain. JAK inhibitors and placebo had a similar incidence of adverse events (RR = 1.01; 95% CI 0.97 to 1.04; p = 0.65).Conclusion
JAK inhibitors could be a potential treatment option for systemic and cutaneous lupus erythematosus, particularly in treating cutaneous and musculoskeletal lesions of SLE. JAK inhibitors had a safe profile.