单位:[1]Tsinghua Univ, Sch Med, Beijing, Peoples R China[2]Beijing Univ Chinese Med, Beijing, Peoples R China[3]China Japan Friendship Hosp, Dept Pulm & Crit Care Med, Natl Ctr Resp Med, Ctr Resp Med,Natl Clin Res Ctr Resp Dis, Beijing, Peoples R China[4]Chinese Acad Med Sci, Inst Resp Med, Beijing, Peoples R China[5]China Japan Friendship Hosp, Inst Clin Med Sci, Beijing, Peoples R China[6]Capital Med Univ, Dept Pulm & Crit Care Med, Beijing, Peoples R China[7]Tsinghua Univ Peking Univ Joint Ctr Life Sci, Beijing, Peoples R China
Background:& nbsp;Cytokine storm observed in patients with severe Coronavirus Disease 2019 (COVID-19) contributes to poor clinical outcomes and increased mortality. Janus kinases (JAKs) are important mediators in the cytokine storm. Therefore, we conduct a living systematic review and meta-analysis of the literature investigating efficacy and safety of JAK inhibitors for patients with COVID-19.& nbsp;Methods:& nbsp;Databases were searched up to December 1, 2021 for interventional and observational studies comparing JAK inhibitor treatment with concurrent control in patients with COVID-19. Efficacy and safety outcomes were evaluated by pooled risk ratio (RR).& nbsp;Results:& nbsp;Of 3,170 records retrieved, 15 studies were eligible and 13 were evaluated in the meta-analysis (n = 3,977). Based on data from three randomized controlled trials (RCTs), baricitinib treatment significantly decreased mortality by day 28 in hospitalized patients with COVID-19 (RR = 0.64, 95% CI 0.51-0.80) without increasing the incidence of adverse outcomes. In subgroup analysis, patients who required supplemental oxygen (RR = 0.62, 95% CI 0.41-0.95) or high-flow oxygen/non-invasive ventilation (RR = 0.59, 95% CI 0.42-0.85) at baseline benefited most. Pooled analysis of all eligible studies for JAK inhibitors (baricitinib, ruxolitinib, tofacitinib, and nezulcitinib) demonstrated a significant decrease in mortality (RR = 0.62, 95% CI 0.49-0.78) with no increase in the risk of adverse events.& nbsp;Conclusion:& nbsp;Baricitinib probably decreases mortality in hospitalized adult patients with COVID-19, especially for patients who required supplemental oxygen or high-flow oxygen/non-invasive ventilation at baseline. The efficacy and safety of other JAK inhibitors, such as ruxolitinib, tofacitinib, and nezulcitinib, await more evidence.
基金:
Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences [2020-I2M-CoV19-005, 2018-I2M-1-003]; National Natural Science Foundation of China [82041011]
第一作者单位:[1]Tsinghua Univ, Sch Med, Beijing, Peoples R China
共同第一作者:
通讯作者:
通讯机构:[3]China Japan Friendship Hosp, Dept Pulm & Crit Care Med, Natl Ctr Resp Med, Ctr Resp Med,Natl Clin Res Ctr Resp Dis, Beijing, Peoples R China[4]Chinese Acad Med Sci, Inst Resp Med, Beijing, Peoples R China[6]Capital Med Univ, Dept Pulm & Crit Care Med, Beijing, Peoples R China[7]Tsinghua Univ Peking Univ Joint Ctr Life Sci, Beijing, Peoples R China
推荐引用方式(GB/T 7714):
Zhang Xueyang,Shang Lianhan,Fan Guohui,et al.The Efficacy and Safety of Janus Kinase Inhibitors for Patients With COVID-19: A Living Systematic Review and Meta-Analysis[J].FRONTIERS in MEDICINE.2022,8:doi:10.3389/fmed.2021.800492.
APA:
Zhang, Xueyang,Shang, Lianhan,Fan, Guohui,Gu, Xiaoying,Xu, Jiuyang...&Cao, Bin.(2022).The Efficacy and Safety of Janus Kinase Inhibitors for Patients With COVID-19: A Living Systematic Review and Meta-Analysis.FRONTIERS in MEDICINE,8,
MLA:
Zhang, Xueyang,et al."The Efficacy and Safety of Janus Kinase Inhibitors for Patients With COVID-19: A Living Systematic Review and Meta-Analysis".FRONTIERS in MEDICINE 8.(2022)