Postgraduate Medical Journal最新文献

{"title":"Effect of remote ischemic conditioning on albuminuria in adults with diabetes mellitus (ricadime): a parallel group, double blind, sham controlled, randomized clinical trial.","authors":"Nishanth Dev, Garima Kumar, Gaurav Singh, Jhuma Sankar","doi":"10.1093/postmj/qgag040","DOIUrl":"10.1093/postmj/qgag040","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic kidney disease (DKD), a chronic microvascular complication is leading cause of End Stage Kidney disease (ESKD). Reduction of ≥30% urinary albumin is recommended to slow ESKD progression. Remote Ischemic conditioning (RIC) induces brief episodes of ischemia and reperfusion and has protective effect on various organs. The current study aims to explore the effects of RIC on albuminuria reduction in adults with type-2 Diabetes Mellitus.</p><p><strong>Materials and methods: </strong>In this double blind, sham controlled, Randomized Clinical Trial, we assigned 40 normotensive Diabetic adults with moderate and severely increased albuminuria to RIC group (n = 20) or Sham group (n = 20) weekly for 8 weeks. Primary outcome was reduction in albuminuria at the end of 8 weeks. Secondary outcomes were changes in serum creatinine, e-Glomerular Filtration Rate (eGFR), and HbA1c levels.</p><p><strong>Results: </strong>The reduction in albuminuria at the end of 8 weeks was 37.9% [Median (IQR): -7.5, 43.9] in the RIC group while it increased by 1.10% (-5.6, 15.2) in the Sham group (P = 0.015). Significant reduction was noted in serum creatinine in RIC group from 1 to 0.83 mg/dl as compared to increase in Sham group from 0.97 to 1.1 mg/dl (P = 0.0004). The mean eGFR in the RIC group improved from 85 to 99 (ml/min/1.73m2) P = 0.0001). No significant change was detected in HbA1C levels. Mild pain was the only adverse effect noted in 10% in the RIC group and none in the Sham group.</p><p><strong>Conclusion: </strong>Among adults with DKD, treatment with RIC significantly reduced albuminuria and serum creatinine while improving the eGFR (CTRI/2024/09/074453).</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"840-846"},"PeriodicalIF":3.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chest pain, troponin, and electrocardiogram: rethinking how we diagnose myocardial ischemia.","authors":"Maria Giulia Bellicini","doi":"10.1093/postmj/qgaf179","DOIUrl":"10.1093/postmj/qgaf179","url":null,"abstract":"<p><p>Chest pain remains one of the most common reasons for emergency department visits and cardiology consultations worldwide. Although structured diagnostic algorithms, such as the European Society of Cardiology, endorsed 0 h/1 h approach, have greatly improved the triage of suspected myocardial infarction, they are designed to be applied only after the clinician has determined that the presenting symptoms may be cardiac in origin. This article focuses on that crucial pre-algorithmic step: helping clinicians recognize which symptom presentations truly warrant consideration for myocardial ischemia. By clarifying how clinical features such as symptom duration, electrocardiogram changes, and troponin kinetics relate to pathophysiology, we aim to support the early identification of potentially ischemic chest pain, before structured pathways are applied. Rather than offering an alternative to current algorithms, this work seeks to enhance their precision and applicability by reinforcing the clinical reasoning required to use them appropriately.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"885-887"},"PeriodicalIF":3.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inability to answer questions: a pragmatic red flag in altered mental status.","authors":"Ali Çelik","doi":"10.1093/postmj/qgag064","DOIUrl":"10.1093/postmj/qgag064","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"883-884"},"PeriodicalIF":3.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mind of artificial intelligence and machine-a fact or fiction?","authors":"Souvik Dubey, Subhankar Chatterjee, Ritwik Ghosh, Samya Sengupta, Mahua Jana Dubey","doi":"10.1093/postmj/qgaf140","DOIUrl":"10.1093/postmj/qgaf140","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"864-866"},"PeriodicalIF":3.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144965988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute kidney injury in rhabdomyolysis defined by serum creatine kinase ≥1000 IU/L: association with creatine kinase levels.","authors":"Zheying Khor, Nadeeka Rathnamalala, Robert Flynn, Christopher Isles","doi":"10.1093/postmj/qgag074","DOIUrl":"10.1093/postmj/qgag074","url":null,"abstract":"<p><strong>Background: </strong>Rhabdomyolysis is a potentially life-threatening consequence of muscle injury. The aim of our study was to analyse the relation between serum creatine kinase (CK), acute kidney injury (AKI), renal outcomes, and mortality among adults with serum CK over 1000 IU/L within 72 h of hospital admission.</p><p><strong>Methods: </strong>Our single-centre cohort study enrolled 855 patients with serum CK over 1000 IU/L. Univariate and multivariate analyses were performed for short- and long-term mortality, based on a logistic regression model and a cox proportional hazards model, respectively.</p><p><strong>Results: </strong>AKI developed in 368 of 855 patients (43%). Those with CK 5001-10 000 IU/L and over 10 000 IU/L were more likely to develop stages 2 and 3 AKI than those with lower levels of serum CK (P = .001 and P < .001, respectively). Renal replacement therapy (RRT) was required by 43 (5.0%) patients during their hospitalization, 15 of whom had pre-existing non-dialysis dependent chronic kidney disease (CKD). The requirement for RRT was greatest among those with serum CK over 5000 IU/L (P < .001). Among the 269 patients with AKI who survived at least 3 years, 235 (87.4%) had complete recovery of renal function, 26 (9.7%) had partial recovery, while 8 (3.0%) remained dialysis dependent. Complete recovery was more likely in patients with stages 1 and 2 AKI than those with stage 3 AKI (P < .018). All eight patients who remained dialysis dependent had initially presented with stage 3 AKI. For patients who were still alive 90 days after hospital admission, neither AKI or CK levels were associated with subsequent mortality. Age was the only predictor of their long-term mortality identified by multivariate analysis.</p><p><strong>Conclusions: </strong>AKI is a common but not inevitable consequence of rhabdomyolysis. Most patients with AKI have complete recovery of renal function. Serum CK predicts likelihood of more severe forms of AKI but has no discernible effect on either short- or long-term mortality. Key messages What is already known on this topic: Acute kidney injury (AKI) is a common and potentially life-threatening complication of rhabdomyolysis. Studies have shown varying results when describing relationship between serum creatine kinase (CK) and AKI. What this study adds: Our study showed an AKI incidence of 43% in patients with serum CK over 1000 IU/L. Most patients with AKI had complete recovery of their renal function. Serum CK over 5000 IU/L predicted likelihood of more severe forms of AKI, including the need for dialysis, but was not associated with either short or long-term mortality. How this study might affect research, practice, or policy: Greater awareness of the relation between serum CK and AKI should prompt preventive measures, including early rehydration and treatment of infection if present, to reduce the incidence of severe AKI.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"876-882"},"PeriodicalIF":3.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of ethambutol versus streptomycin during the intensive phase in treatment of tuberculous meningitis: an open-label randomized clinical trial.","authors":"Mritunjai Kumar, Anu Singh, Rajni Singh, Nikita Dhar, Jagbir Singh, Ashutosh Tiwari, Niraj Kumar","doi":"10.1093/postmj/qgag021","DOIUrl":"10.1093/postmj/qgag021","url":null,"abstract":"<p><strong>Background: </strong>The choice of the fourth drug in anti-tubercular therapy for adults with tuberculous meningitis (TBM) remains uncertain. This trial compared the effectiveness and safety of ethambutol (ETM) versus streptomycin (STM) during the intensive phase.</p><p><strong>Methods: </strong>This is an investigator-initiated, single-center, open-label, randomized controlled trial conducted during October 2020-June 2025. The study was stopped early because of slow recruitment. Patients were randomized to receive either STM (15 mg/kg intramuscular daily; ~90 injections) with isoniazid (H) 5 mg/kg (~300 mg/d), rifampicin (R) 10 mg/kg (~600 mg/d), and pyrazinamide (Z) 25 mg/kg (~1500 mg/d), or ETM (15 mg/kg orally daily) with HRZ for 6 months, followed by RH for 12 months in both arms. Primary outcome was mortality at 6 months. Secondary outcomes included in-hospital mortality and neurologic disability at 3 and 6 months. The disability was assessed using the modified Rankin Scale (mRS) as good (mRS ≤ 2) or poor (mRS > 2). Adverse events were noted.</p><p><strong>Results: </strong>Of 131 patients screened, 49 were excluded. The results therefore are based on 82 patients. The two arms were matched for baseline characteristics. At 6 months, 26 patients had died: 12/42 (28.6%) in the STM arm and 14/40 (35%) in the ETM arm (hazard ratio: 0.78; 95% confidence interval: 0.36-1.70; P = 0.54). In intention-to-treat analysis, there were no differences in in-hospital mortality and disability at 3 and 6 months. Two patients each developed ototoxicity and vision loss in the STM and the ETM arm, respectively.</p><p><strong>Conclusions: </strong>In adults with TBM, there was no difference in mortality or disability at 6 months between ETM and STM arms, but the study may lack statistical power to detect a difference.The trial was registered in the Clinical Trials Registry of India, CTRI/2020/07/026423 (registered on: 7 July 2020). Key messages What is already known on this topic: The choice of the fourth drug in anti-tubercular therapy (ATT) for adults with tuberculous meningitis (TBM) remains uncertain. Despite extensive use, direct comparisons of ethambutol (ETM) versus streptomycin (STM) in TBM through randomized controlled trials are lacking. What this study adds: In adults with TBM, there was no difference in mortality or disability at 6 months between ETM- or STM-based ATT regimens during the intensive phase. How this study might affect research, practice, or policy: The safety profile of both drugs was comparable; hence, the choice of fourth drug may instead be guided by safety and feasibility.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"826-832"},"PeriodicalIF":3.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Doctors are encouraged to undertake research-but the system makes it far too difficult.","authors":"Harrison Charles Duell, Mary Shifona Kumarasingam","doi":"10.1093/postmj/qgaf152","DOIUrl":"10.1093/postmj/qgaf152","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"862-863"},"PeriodicalIF":3.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the cardiology training landscape in Asia-Pacific region.","authors":"Fathima Aaysha Cader, Wei Yi Sean Lee, Wishnu Aditya Widodo, Raja Ezman Raja Shariff, Mohammed S Al-Omary, Gary Gan, Derek Pok Him Lee, Malis Vorn, Francis Lim, Amit Omprakash Singh, Habib Faisal, Negar Salehi, Misato Chimura, Satoshi Honda, Tan Chen Ting, Samshol Bin Sukahri, Akmal Arshad, Rhuban M Sundran, Ganchimeg Ulziisaikhan, Thant Zaw Lwin, Thein Htat Thein, Kevin Thein Tun, Arun Maskey, Bernard Wong, Zille Huma, Lucky Cuenza, Dong-Hyuk Cho, Uditha Indika Hewarathna, Wei-Ting Chang, Purich Surunchupakorn, Juwairia Yousif Alali, Phan Tuan Dat, Do Van Chien, Yann Shan Keh, Jack Wei Chieh Tan, Yew Min Sen, Jonathan Yap","doi":"10.1093/postmj/qgag050","DOIUrl":"10.1093/postmj/qgag050","url":null,"abstract":"<p><strong>Background: </strong>Considerable diversity in cardiology training and credentialing pathways exist within the Asia-Pacific. We aimed to map these variations and report similarities and disparities with a view to understanding needs in cardiology curricula development in the region.</p><p><strong>Methods: </strong>A 42-item online questionnaire was distributed to credentialed cardiologists serving as representatives from various regions within the Asia-Pacific, allowing obtainment of region-specific data as of December 2023. Responses were derived from a total of 23 regions.</p><p><strong>Results: </strong>All regions required specialist qualification to practise cardiology. Overall, 69.6% have a single training pathway, while 21.7% and 8.7% have two or three pathways, respectively. Majority (91.3%) had structured cardiology training curricula with assigned supervisor and regular assessments. The majority (91.3%) required mandatory training in internal medicine prior to cardiology. The total training duration inclusive of medicine and cardiology varied across regions (range 3-8 years) with 26.1% lasting 5 years and 43.5% lasting 6 years. All programmes had mandatory clinical cardiology training; 82.6% had interventional cardiology, 73.9% had electrophysiology, 73.9% had cardiac imaging training. However, 47.8% of regions had no training in cardiac computerized tomography (CT) and 56.5% had no cardiac magnetic resonance (CMR) imaging. 73.9% required mandatory research for board certification. In addition, 95.1% had an exit exam at completion of training (local in 95% cases). Board certification was mandatory for general cardiology practise in 69.6% of regions. Separate subspeciality fellowships were mandatory in 73.9% of regions.</p><p><strong>Conclusions: </strong>Significant regional variations in cardiology training and credentialing pathways exist, presenting opportunities to harmonize and improve training metrics regionally. Key message What is already known on the topic? Cardiology training within the Asia-Pacific region has considerable variation in terms of duration, curriculum, training, and exit requirements. What this study adds? This study outlines the similarities and differences of cardiology training between different countries within the Asia-Pacific region. How this study might affect research, practise or policy? Results from this study provide insights that may inform the development of harmonized and contextually appropriate cardiology curricula in the Asia-Pacific region. Establishing common standards for cardiology training could facilitate a more uniform and coherent curriculum across Asia, ensuring consistency in trainee competencies and clinical practise.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"847-854"},"PeriodicalIF":3.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysregulation of PIWI-interacting RNA-63049 (piRNA-63049) is associated with increased risk of post-menopausal osteoporosis in Chinese population via regulating the Wnt signaling pathway.","authors":"Yu Cong, Xing Zhou, Nirong Bao, Peng He","doi":"10.1093/postmj/qgae138","DOIUrl":"10.1093/postmj/qgae138","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;This study investigates the association between PIWI-interacting RNA-63049 (piRNA-63049) and the risk of post-menopausal osteoporosis in a Chinese population. It explores piRNA-63049's role in modulating the Wnt signaling pathway, which is crucial for bone health, particularly in the context of estrogen deficiency-induced osteoporosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We enrolled 216 participants divided into three groups: healthy control participants as the osteoporosis(-)fracture(-) group, osteoporosis patients without fractures as the osteoporosis(+)fracture(-) group, and osteoporosis patients with fractures as the osteoporosis(+)fracture(+) group. T-scores at both spine and hip were compared. The expression of piRNA-63049 and its impact on the Wnt/β-catenin signaling pathway were examined using polymerase chain reaction analysis and luciferase assays.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared with other candidate piRNAs, piRNA-63049 exhibited significantly higher expression levels in patients with osteoporosis, while being highest in osteoporosis patients with fractures. T-scores of the osteoporosis(+)fracture(+) were also the lowest among all groups, which indicated worse bone health compared with the osteoporosis(+)fracture(-) group. Luciferase assays confirmed the molecular interactions between piRNA-63049 and the Wnt2b mRNA and β-catenin mRNA, both being crucial components of the Wnt signaling pathway. Overexpression of piRNA-63049 resulted in the downregulation of several key genes involved in bone metabolism, further elucidating its critical role in osteogenesis and bone health. Moreover, key genes of bone metabolism including LRP5, LRP6, OCN, OPN, and ALP were also regulated by the overexpression of piRNA-63049.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our study suggested that the dysregulation of piRNA-63049 is associated with the increased risk of post-menopausal osteoporosis and fractures in the Chinese population by modulating the Wnt/β-catenin signaling pathway. Key messages What is already known on this topic: Post-menopausal osteoporosis was recognized for its significant bone loss and increased fracture risk, largely due to estrogen deficiency disrupting bone remodeling. The Wnt signaling pathway was identified as a key regulator in bone metabolism, with its dysregulation linked to osteoporosis. However, the specific role of piRNA-63049 was not well understood, which requested further research into its regulatory functions and its connection to osteoporosis in the Chinese population. What this study adds: This study reveals that piRNA-63049 is significantly upregulated in post-menopausal osteoporosis patients, particularly in those with fractures, and demonstrates a direct molecular interaction between piRNA-63049 and the Wnt/β-catenin signaling pathway. How this study might affect research, practice, or policy: The study's findings have implications for developing targeted therapies for osteoporosis, as piRNA","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"833-839"},"PeriodicalIF":3.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy of Janus kinase inhibitors in severe alopecia areata: a network meta-analysis based on randomized controlled trials.","authors":"Yinfeng Xia, Hong Chen, Yongsong Chen, Zhiyong Chen","doi":"10.1093/postmj/qgaf189","DOIUrl":"10.1093/postmj/qgaf189","url":null,"abstract":"<p><strong>Background: </strong>Alopecia areata (AA), an autoimmune disorder, represents a prevalent form of hair loss among individuals. Various therapeutic approaches exist for managing AA, with Janus kinase (JAK) inhibitors emerging as a promising treatment modality. Nonetheless, there is a paucity of rigorous studies directly comparing the efficacy of JAK inhibitors in cases of severe AA.</p><p><strong>Objective: </strong>Evaluating the efficacy of different JAK inhibitors in the treatment of severe AA.</p><p><strong>Method: </strong>A comprehensive search was conducted across four databases-PubMed, Embase, Web of Science, and Cochrane Library-on February 10, 2025. Eligible studies were selected based on the PICOS framework. A Bayesian network meta-analysis was employed to extract and analyze data concerning the number of individuals achieving SALT20 and corresponding sample sizes. The relative efficacy of the interventions was evaluated using league tables and Surface Under the Cumulative Ranking values.</p><p><strong>Result: </strong>A total of 3866 patients with AA were included in the study, with a total of 10 interventions. Of these, the one that showed the best efficacy was deuruxolitinib_12 mg, but with wider 95% confidence intervals. Of all the JAK inhibitors, the one with significant efficacy and high precision of results was baricitinib_4 mg (OR: 2.59, 95% CI: 1.98-3.38).</p><p><strong>Conclusion: </strong>The efficacy of JAK inhibitors in the treatment of severe AA is definitive, and all possess a dose-dependent effect. This study provides valuable insights for clinicians in selecting appropriate pharmacological interventions for severe AA. Key messages What is already known on this topic: Alopecia areata is an autoimmune disorder characterized by patchy hair loss on the scalp. Previous studies have demonstrated that JAK inhibitors can effectively treat alopecia areata, but research comparing the efficacy of different JAK inhibitors is lacking. What this study adds: This study established a ranking of efficacy for different JAK inhibitors in treating severe alopecia areata, providing a reference for selecting clinical treatment regimens. How this study might affect research, practice, or policy: Future studies are needed to directly compare the efficacy of different JAK inhibitors in treating alopecia areata. This will provide more reliable evidence for formulating treatment regimens for alopecia areata.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"855-861"},"PeriodicalIF":3.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}