Janus kinase (JAK) inhibitors demonstrate safety and efficacy, as well as improve physical function, emotional well-being, and social participation, among patients with active ankylosing spondylitis (AS), according to study results published in European Journal of Internal Medicine.
The aim of the systematic review and meta-analysis was to assess the safety and efficacy of JAK inhibitors in the treatment of AS.
The study included 4 randomized controlled trials published by November 2021 from the Cochrane Central Register of Controlled Trials and PubMed. A total of 779 participants were included in these studies, with each study evaluating JAK inhibitors in treating AS. Data extracted included participant characteristics, interventions, outcomes, and adverse and severe adverse events.
Treatment for AS was scored using the Assessment of Spondyloarthritis International Society (ASAS) 20, 40, 5/6; the Bath AS Disease Activity Index (BASDAI) 50; changes in AS disease activity score using C-reactive protein; functional Assessment of Chronic Illness Therapy-fatigue score; AS Quality of Life score; Maastricht AS enthesitis score; Bath AS Functional Index; Short-Form (SF)-36 health survey physical component summary score; Bath AS metrology index; Spondyloarthritis Research Consortium of Canada (SPARCC) joint score; and Work Productivity and Activity Impairment Overall Work Impairment score.
The I2 test was used to evaluate heterogeneity among studies; any heterogeneity was accounted for using a random-effects model.
The JAK-inhibitor group showed significantly higher responses compared with placebo for all assessments, except for SF-36 mental component score (P ≤.03 for all). No significant difference was found between the JAK inhibitor and placebo groups regarding adverse events or serious adverse events.
Limitations to the analysis included a relatively small number of studies, potential selection and publication bias, an inability to determine whether a particular JAK inhibitor was safer or more effective than the other, and the inability to rule out bias based on certain participant characteristics.
The study authors concluded that there is “solid evidence for JAK [inhibitors] as a new direction and novel therapeutic strategy for the patients with active AS.” However, they noted that further research is needed “to assess the long-term efficacy and safety of JAK inhibitors.”
Li S, Li F, Mao N, Wang J, Xie X. Efficacy and safety of Janus kinase inhibitors in patients with ankylosing spondylitis: a systematic review and meta-analysis. Published online April 20, 2022. Eur J Intern Med. doi:10.1016/j.ejim.2022.04.007