Efficacy and Safety of JAK-STAT Inhibitors in the Treatment of Moderate to Severe Plaque Psoriasis: a Meta Analysis

Abstract

Objective: To systematically evaluate the efficacy and safety of JAK-STAT inhibitors in the treatment of moderate to severe plaque psoriasis. Methods: We conducted a computerized search of relevant published literature in the PubMed, EMBASE, and Cochrane Library databases from their inception to May 2024. We included randomized controlled trials comparing JAK-STAT inhibitors to placebo. Two researchers independently screened the literature and extracted data. The quality of the included studies was assessed using the bias risk assessment tool provided in the Cochrane Systematic Reviews Handbook 5.1.0. We performed a meta-analysis on the effectiveness and safety of JAK-STAT inhibitors for treating moderate to severe plaque psoriasis using RevMan 5.4 software. Results: Seven studies with a total of 1830 patients were included. Meta-analysis revealed that in the JAK-STAT inhibitors group, the proportion of patients achieving a 75% reduction in Psoriasis Area and Severity Index (PASI) scores [RR=6.49, 95% CI (4.07, 10.34), P<0.0001], a Static Physician Global Assessment (sPGA) score of 0 or 1 [RR=4.60, 95% CI (3.08, 6.85), P<0.0001], a Dermatology Life Quality Index (DLQI) score of 0 or 1 [RR=2.73, 95% CI (2.16, 3.44), P<0.0001], and an Itching Scale (ISS) score of 0 or 1 [RR=5.84, 95% CI (3.69, 9.24), P<0.0001] was significantly higher than in the placebo group; The incidence of Total AEs in the JAK-STAT inhibitors group was marginally higher than in the placebo group [RR=1.19, 95% CI (1.01, 1.41), P=0.04], with no statistically significant difference in SAEs between the two groups (P>0.05). Conclusion: JAK-STAT inhibitors demonstrate significant clinical efficacy in treating moderate to severe plaque psoriasis, with most adverse reactions being mild to moderate. Patients exhibit good adherence and tolerability, suggesting their potential as an alternative therapy in clinical practice.