JAK inhibitors promising for treatment of psoriasis and psoriatic arthritis

Canada: The treatment of moderate-to-severe psoriasis and psoriatic arthritis (PsA) with Janus Kinase (JAK) inhibitors is safe and appears promising, says an article published in BMC Rheumatology journal.

Moderate-to-severe psoriasis and psoriatic arthritis may benefit from the use of JAK inhibitors, a relatively new family of drugs. With the aim of evaluating safety issues and the effectiveness of several JAK inhibitors in treating psoriasis and PsA, Samantha Sarabia and colleagues conducted this study.

Cochrane, MEDLINE, and EMBASE were searched for randomized clinical trials and observational research comparing any JAK inhibitor versus placebo. The major goals were to enhance the Psoriasis Area and Severity Index (PASI75) by 75% and the American College of Rheumatology composite score by 20% (ACR20). The proportion of patients scoring a "0" or "1" on the static Physician Global Assessment scale was a secondary objective. The proportion of patients attaining these objectives in the max dosage intervention group vs. the placebo group was compared using odds ratios. To accommodate for heterogeneity, a random effects model was applied.

The key findings of this study were;

1. The study included 15 RCTs in total and excluded any observational studies. This included a total of 6757 patients.

2. When the data were combined, the odds ratios for PASI75 with tofacitinib versus placebo were OR 14.35, for PASI75 with JAK inhibitors other than tofacitinib versus placebo, were OR 6.42, and for ACR20 with all JAK inhibitors versus placebo were OR 5.87.

3. In none of these trials was there a significant difference in the prevalence of major adverse events between intervention and control.

In conclusion, this research supports the use of JAK inhibitors as an alternative treatment for those with skin and joint diseases who have not responded well to other biologic DMARDS or who prefer oral to injectable drugs. To evaluate JAK inhibitors' ideal function in treating psoriatic illness and its numerous symptoms, more studies will be required to compare them directly to one another and to other treatments with alternative mechanisms of action.

Reference: 

Sarabia, S., Ranjith, B., Koppikar, S., & Wijeratne, D. T. (2022). Efficacy and safety of JAK inhibitors in the treatment of psoriasis and psoriatic arthritis: a systematic review and meta-analysis. In BMC Rheumatology (Vol. 6, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s41927-022-00287-7