Efficacy and safety of upadacitinib, a selective JAK-1 inhibitor in treatment of ankylosing spondylitis: a meta-analysis.

IF 2.1 Q3 RHEUMATOLOGY

BMC Rheumatology Pub Date : 2025-02-18 DOI:10.1186/s41927-025-00467-1

Qi Yao, Yixuan Zhu, Yanling Ma, Yanfang Pu, Xueting Yang, Zhiqing Zhang

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引用次数: 0

Abstract

Objective: To systemically assess efficacy and safety of upadacitinib (UPA), a selective inhibitor of Janus kinase 1 (JAK1) in treatment of ankylosing spondylitis (AS).

Methods: Available databases were used to retrieve literatures of randomized controlled trials (RCTs) of UPA for AS treatment until February 2024. After that, the data were extracted and the Revman 5.4 software was used to conduct a meta-analysis.

Results: A total of 6 articles and 1653 patients (920 in a UPA group (15 mg, q.d) and 733 in a placebo group) were selected in this study. Respectively, UPA treatment significantly increased numbers of the AS patients having 40%, 20%, or partial remission (PR) improvement in assessment of spondylo arthritis international society (ASAS) (ASAS 40: 95%CI: 2.41-4.3, p < 0.00001; ASAS 20: 95%CI: 2.12-3.62, p < 0.00001; ASAS PR: 95%CI: 2.81-7.48, p < 0.00001), Bath ankylosing spondylitis disease activity index (BASDAI50) (95%CI: 2.28 ~ 4.10, p < 0.00001), quality of life (95%CI: 2.06 ~ 3.17, p < 0.00001), AS disease activity score low disease activity (ASDAS LDA) (95%CI: 3.07~9.96, p < 0.00001), ASDAS inactive disease (ID) (95%CI: 2.03 ~ 17.22, p = 0.001), short-form 36 physical component summary (SF-36PCS) (95%CI: 1.53 ~2.81, p < 0.00001), and markedly reduced ASDAS C-reactive protein (CRP) (95%CI: -1.22 ~ -0.42, p < 0.0001), total back pain score (95%CI: -2.01 ~ -0.51, p = 0.001), nighttime back pain score (95%CI: -1.96 ~ -0.54, p = 0.0006), spondylo arthritis research consortium of Canada magnetic resonance imaging (SPARCC MRI) spine score (95%CI: -7.78--3.50, p < 0.00001) and SPARCC MRI sacroiliac joint score (95%CI: -5.99 - -3.09, p < 0.00001), Bath ankylosing spondylitis function index (BASFI) score (95%CI: -1.45 ~ -0.81, p < 0.00001), Maastricht ankylosing spondylitis enthesitis score (MASES) (95%CI: -2.34~-0.35, p = 0.008). Except for neutropenia (95%CI: 1.25 ~ 15.60, p = 0.02), no other adverse effects (AEs) were significantly different between the UPA treatment and placebo.

Conclusions: Through a literature analysis, it reveals that UPA offers significant therapeutic benefits to AS patients with a relatively high safety profile.

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选择性JAK-1抑制剂upadacitinib治疗强直性脊柱炎的疗效和安全性：一项荟萃分析

目的：系统评价Janus激酶1 （JAK1）选择性抑制剂upadacitinib （UPA）治疗强直性脊柱炎（AS）的疗效和安全性。方法：利用现有数据库检索截至2024年2月的UPA治疗AS的随机对照试验（rct）文献。之后提取资料，使用Revman 5.4软件进行meta分析。结果：本研究共纳入6篇文章和1653例患者（UPA组920例（15mg, q.d），安慰剂组733例）。在国际脊柱关节炎协会（ASAS）的评估中，UPA治疗分别显著增加了40%、20%或部分缓解（PR）改善的AS患者数量（ASAS 40: 95%CI: 2.41-4.3, p）。结论：通过文献分析，UPA对AS患者具有显著的治疗益处，并且具有相对较高的安全性。

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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