Vasculitis & polymyalgia rheumatica
Janus Kinase inhibitors in refractory Takayasu arteritis: a systematic review and proportion meta-analysis of efficacy and safety
Authors' conclusion
JAK inhibitors demonstrate promising clinical efficacy and a potentially manageable safety profile in refractory TAK. However, the available evidence is predominantly observational and therefore subject to confounding and other sources of bias. High-quality prospective and randomized studies are needed to establish their efficacy, comparative effectiveness, and long-term safety.
Study context
- Population
- Adults with refractory Takayasu arteritis (TAK) treated with JAK inhibitors, in observational cohorts, non-randomized interventional studies, and case series including ≥5 patientspatients in eleven included studies
- Participants
- 185 adults
- Outcome
- Clinical remission (pooled rate)
Methodological detailsproportion meta-analysis, random-effects models, Risk of bias assessed using Cochrane ROBINS-I and Joanna Briggs Institute tools, GRADE
- Proportion meta-analysis
- Random-effects models
- Risk of bias assessed using Cochrane ROBINS-I and Joanna Briggs Institute tools
- GRADE
Pooled result
As reported in the abstract
Pooled clinical remission rate
64%
95% CI 55%–72%; I²=0%
Further pooled results
Complete and partial remission (pooled rates)
- Complete remission
- 65% (95% CI, 55%-74%)
- Partial remission
- 8% (95% CI, 4%-17%)
No response and relapse (pooled rates)
- No response
- 24%
- Relapse
- 14%
Imaging improvement or stabilization
- Imaging improvement or stabilization
- 44%
Glucocorticoid-sparing effects
- Glucocorticoid-sparing effects
- 56%
GRADE certainty
- GRADE certainty was very low for all assessed outcomes
Safety
- Adverse events
- 10%
- Discontinued treatment because of adverse events
- 7%
Original publication
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