Janus kinase inhibitors in rheumatoid arthritis-associated interstitial lung disease: A systematic review and meta-analysis

IF 9.2 1区医学 Q1 IMMUNOLOGY

Autoimmunity reviews Pub Date : 2024-09-11 DOI:10.1016/j.autrev.2024.103636

Javier Narváez , Martí Aguilar-Coll , Montserrat Roig-Kim , Pol Maymó-Paituvi , Judith Palacios-Olid , Joan Miquel Nolla , Dídac LLop

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引用次数: 0

Abstract

Objective

The treatment of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) remains challenging due to the scarcity of proven effective therapeutic options. This study aimed to investigate the effectiveness and safety of Janus kinase inhibitors (JAKi) in RA-ILD.

Methods

We systematically reviewed the literature to identify studies evaluating the efficacy and safety of JAK inhibitors in RA-ILD. A meta-analysis was performed using the random-effects model.

Results

The literature search identified seven observational studies assessing the safety and efficacy of JAKi in RA-ILD and three studies analyzing the risk of developing de novo ILD in RA patients treated with JAKi.

Among 183 patients with RA-ILD, the pooled analysis demonstrated an increase of 2.07 % in %pFVC (95 % CI: 0.57–3.58; p = 0.007) and 3.12 % in %pDLCO (95 % CI: 2.11–4.12; p < 0.001). Thoracic HRCT scans showed improvement in 11 % of patients (95 % CI: 0.01–0.29). The pooled proportion of patients experiencing worsening of pre-existing ILD was 5 % (95 % CI: 0.01–0.11).

Adverse events were reported in 14 % of cases (95 % CI: 0.08–0.21), with the frequency of clinically significant infections ranging from 4.5 % to 25 %.

The risk of developing de novo ILD in patients receiving JAKi was low, with an incidence rate of 0.20 per 1000 person-years (95 % CI: 0.14–0.25). Comparisons with abatacept and rituximab suggested similar efficacy and safety profiles.

Conclusion

JAKi are well tolerated and might be a viable treatment option for RA-ILD, offering comparable safety and efficacy to abatacept and rituximab.

查看原文本刊更多论文

类风湿性关节炎相关间质性肺病中的 Janus 激酶抑制剂：系统回顾和荟萃分析。

目的：由于缺乏行之有效的治疗方案，类风湿性关节炎相关性间质性肺病（RA-ILD）的治疗仍面临挑战。本研究旨在探讨Janus激酶抑制剂（JAKi）在RA-ILD中的有效性和安全性：我们系统地查阅了相关文献，以确定评估JAK抑制剂在RA-ILD中疗效和安全性的研究。采用随机效应模型进行了荟萃分析：文献检索发现了七项评估JAKi在RA-ILD中安全性和有效性的观察性研究，以及三项分析接受JAKi治疗的RA患者发生新生ILD风险的研究。在183例RA-ILD患者中，汇总分析结果显示，%pFVC增加了2.07%（95% CI：0.57-3.58；p = 0.007），%pDLCO增加了3.12%（95% CI：2.11-4.12；p 结论：JAKi对RA-ILD患者的耐受性和疗效良好：JAKi耐受性良好，可作为RA-ILD的可行治疗方案，其安全性和有效性与阿帕他赛和利妥昔单抗相当。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Autoimmunity reviews 医学-免疫学

CiteScore

24.70

自引率

4.40%

发文量

164

审稿时长

21 days

期刊介绍： Autoimmunity Reviews is a publication that features up-to-date, structured reviews on various topics in the field of autoimmunity. These reviews are written by renowned experts and include demonstrative illustrations and tables. Each article will have a clear "take-home" message for readers. The selection of articles is primarily done by the Editors-in-Chief, based on recommendations from the international Editorial Board. The topics covered in the articles span all areas of autoimmunology, aiming to bridge the gap between basic and clinical sciences. In terms of content, the contributions in basic sciences delve into the pathophysiology and mechanisms of autoimmune disorders, as well as genomics and proteomics. On the other hand, clinical contributions focus on diseases related to autoimmunity, novel therapies, and clinical associations. Autoimmunity Reviews is internationally recognized, and its articles are indexed and abstracted in prestigious databases such as PubMed/Medline, Science Citation Index Expanded, Biosciences Information Services, and Chemical Abstracts.