JAK Inhibitors Examined for Efficacy in Psoriatic Diseases

Janus kinase inhibitors (JAK) appear to be effective for the treatment of moderate to severe psoriatic arthritis and plaque psoriasis compared with placebo, according to results from a systematic review and meta-analysis published in BMC Rheumatology.

“Our study supports the use of JAK inhibitors as an alternative therapy for those who have not been successfully treated with other biologic disease-modifying antirheumatic drugs or for those who prefer oral to injectable medications for both skin and joint disease,” wrote corresponding author Don Thiwanka Wijeratne, MD, of Queen’s University School of Medicine, Ontario, Canada, and coauthors.

The review and meta-analysis included 15 randomized controlled trials that compared various JAK inhibitors to placebo and spanned a total 6757 patients.

When researchers combined results from the studies, odds ratios for achieving 75% improvement in the Psoriasis Area and Severity Index (PASI75) were 14.35 for tofacitinib and 6.42 for non-tofacitinib JAK inhibitors compared with placebo. The odds ratio for a 20% improvement in the American College of Rheumatology composite score (ACR20) was 5.87 for all JAK inhibitors compared with placebo, according to the study.

Combined odds ratios for achieving a 0 or 1 on the static Physician Global Assessment scale, a secondary outcome in the study, were 14.37 for tofacitinib and 16.67 for non-tofacitinib JAK inhibitors compared with placebo, researchers reported.

Analyses revealed no significant differences in the rate of serious adverse events between JAK inhibitors and placebo.

“More research will need to be done,” researchers advised, “to directly compare JAK inhibitors to each other and to other therapies with different mechanisms of action to determine their optimal role in treating psoriatic disease and its various manifestations.”

—Jolynn Tumolo

Reference
Sarabia S, Ranjith B, Koppikar S, Wijeratne DT. Efficacy and safety of JAK inhibitors in the treatment of psoriasis and psoriatic arthritis: a systematic review and meta-analysis. BMC Rheumatol. 2022;6(1):71. https://doi.org/10.1186/s41927-022-00287-7