Systematic review with meta‐analysis: efficacy and safety of oral Janus kinase inhibitors for inflammatory bowel disease
作者： Christopher Ma , Jeffrey K. Lee , Anish R. Mitra , Anouar Teriaky , Daksh Choudhary
DOI: 10.1111/APT.15297
关键词: Tofacitinib 、 Placebo 、 Filgotinib 、 Inflammatory bowel disease 、 Medicine 、 Meta-analysis 、 Relative risk 、 Gastroenterology 、 Ulcerative colitis 、 Janus kinase 、 Internal medicine
摘要: BACKGROUND Janus kinase (JAK) inhibitors represent a novel therapeutic class for treatment of inflammatory bowel disease. AIMS To determine the efficacy and safety JAK compared to placebo Crohn's disease (CD) ulcerative colitis (UC). METHODS PubMed, Embase CENTRAL were systematically searched November 1, 2018. Randomised placebo-controlled trials (RCTs) in adult patients with CD or UC eligible. Open-label extension studies without comparator arm excluded. Clinical, endoscopic, outcomes extracted rates relative pooled using random-effects model. RESULTS A total 12 RCTs (5 CD, 7 UC) included. Patients randomised (n = 844), tofacitinib (n = 1882), filgotinib (n = 130), peficitinib (n = 176), upadacitinib (n = 387) TD-1473 (n = 31). inhibitor was associated induction clinical remission (RR, risk 1.38 [95% confidence interval CI 1.04-1.83], P = 0.025, I2 = 14%) (RR 3.07 2.03-4.63], P < 0.001, = 0%). In UC, endoscopic (endoscopic Mayo subscore MCSe = 0/1) 2.43 1.64-3.59], = 27%) mucosal healing (MCSe = 0) 5.50 2.46-12.32], increased infection 1.40 1.18-1.67], = 0%), particularly herpes zoster. CONCLUSIONS are effective inducing although an infectious complications.
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