Yunha Kim, Gayeong Seo, Jacob J. E. Koopman, Jeong Yee
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引用次数: 0
摘要
目的：本研究的目的是通过对现实世界研究数据进行系统回顾和荟萃分析，评估JAK抑制剂对中重度特应性皮炎患者的有效性和安全性。设计：系统回顾和荟萃分析。采用Freeman-Tukey双反正弦法对有效性和安全性进行综合评估。采用I2统计量评估统计异质性。采用随机效应模型（dersimonan - laird方法）来考虑研究内部和研究之间的异质性，并给出更保守的估计。使用国家心脏、肺和血液研究所开发的研究质量评估工具。数据来源：相关研究于2025年3月通过PubMed、Embase、Scopus和Web of Science四个数据库检索。入选标准：在现实环境中评估系统性JAK抑制剂在中度至重度特应性皮炎患者中的有效性或安全性的研究被纳入。结果：本综述共纳入50项研究。关于它们的有效性，在4、8、12、16、24和52周时，湿疹面积和严重程度指数(EASI)-75 95% CI的汇总估计分别为44%（34%-55%）、45%（28%-62%）、59%（51%-66%）、73%（64%-81%）、70%（57%-81%）和86%（72%-96%）。安全性方面，最常见的不良事件是痤疮（16%），其次是肌酸磷酸激酶水平升高（13%）和血脂升高（12%）。结论：我们对JAK抑制剂治疗特应性皮炎患者的荟萃分析表明，现实环境的总体结果与临床试验的结果相当。系统评价注册：方案注册：PROSPERO CRD42024569258。
Real-World Effectiveness and Safety of JAK Inhibitors in Atopic Dermatitis: A Systematic Review and Meta-Analysis
Objective
The aim of this study is to evaluate the effectiveness and safety of JAK inhibitors in patients with moderate to severe atopic dermatitis by performing a systematic review and meta-analysis using data from studies in real-world settings.
Design
Systematic review and meta-analysis. Pooled estimates for effectiveness and safety were assessed using the Freeman–Tukey Double ArcSine method. Statistical heterogeneity was assessed using I2 statistics. A random-effects model (DerSimonian-Laird method) was applied to consider the heterogeneity within and between studies and to give a more conservative estimate. The study quality assessment tools developed by the National Heart, Lung, and Blood Institute were used.
Data Source
Relevant studies were searched in March 2025 using four databases: PubMed, Embase, Scopus, and Web of Science.
Eligibility Criteria
Studies evaluating the effectiveness or safety of systemic JAK inhibitors among patients with moderate to severe atopic dermatitis in a real-world setting were included.
Results
A total of 50 studies were included in this review. Regarding their effectiveness, the pooled estimates with a 95% CI of Eczema Area and Severity Index (EASI)-75 were 44% (34%–55%), 45% (28%–62%), 59% (51%–66%), 73% (64%–81%), 70% (57%–81%), and 86% (72%–96%) at 4, 8, 12, 16, 24, and 52 weeks. For safety, the most common adverse events were acne (16%), followed by increased creatine phosphokinase levels (13%) and increased lipids (12%).
Conclusion
Our meta-analysis of JAK inhibitors in patients with atopic dermatitis demonstrated that the overall outcomes from real-world settings are comparable to those from clinical trials.
期刊介绍：
Clinical & Experimental Allergy strikes an excellent balance between clinical and scientific articles and carries regular reviews and editorials written by leading authorities in their field.
In response to the increasing number of quality submissions, since 1996 the journals size has increased by over 30%. Clinical & Experimental Allergy is essential reading for allergy practitioners and research scientists with an interest in allergic diseases and mechanisms. Truly international in appeal, Clinical & Experimental Allergy publishes clinical and experimental observations in disease in all fields of medicine in which allergic hypersensitivity plays a part.
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