Comparative efficacy and safety of JAK/TYK2 inhibitors and other oral drugs for moderate-to-severe plaque psoriasis: A systematic review and network meta-analysis

Yaxuan Zheng, Yue Han, Jincong Chen, Jiahao Huang, Changhua Zhu, Lihang Lin, Huichun Su
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Abstract

Janus kinase (JAK)/tyrosine kinase 2 (TYK2) inhibitors are novel treatments for moderate-to-severe plaque psoriasis. To perform a network meta-analysis to compare the efficacy and safety of TYK2 inhibitors with other oral drugs in moderate-to-severe psoriasis. Eligible randomised clinical trials (RCTs) were identified from public databases (published before November 2, 2023). Random-effect frequentist network meta-analysis was performed with ranking based on the surface under the cumulative ranking curve (SUCRA) of Physician’s Global Assessment of “clear” or “almost clear” (PGA 0/1), 75% reduction from baseline in Psoriasis Area and Severity Index (PASI-75). Twenty RCTs containing 7,564 patients with moderate-to-severe psoriasis were included. Deucravacitinib at all dose levels (except for 3 mg every other day) and tofacitinib (10 mg BID) ranked best in achieving PGA 0/1 and PASI-75 at 12– 16 weeks. Tofacitinib (10 mg BID) was considered the most unsafe. Analysis of Ranking according to efficacy and safety showed deucravacitinib (3 mg QD and 3 mg BID) was the best treatment. Analysis of Ranking according to efficacy and safety showed deucravacitinib (3 mg QD and 3 mg BID) was the best treatment. Insufficiency of eligible data and no long-term follow-up data. Deucravacitinib showed superior efficacy and safety for treating moderate-to-severe psoriasis over other included drugs.
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JAK/TYK2抑制剂和其他口服药物治疗中重度斑块状银屑病的疗效和安全性比较:系统综述和网络荟萃分析
Janus激酶(JAK)/酪氨酸激酶2(TYK2)抑制剂是治疗中重度斑块状银屑病的新型疗法。目的是进行一项网络荟萃分析,比较TYK2抑制剂与其他口服药物对中重度银屑病的疗效和安全性。进行了随机效应频数网络荟萃分析,根据累计排序曲线下表面(SUCRA)的 "清晰 "或 "基本清晰"(PGA 0/1)、银屑病面积和严重程度指数(PASI-75)比基线降低75%进行排序。在12-16周达到PGA 0/1和PASI-75方面,所有剂量水平的Deucravacitinib(隔日3毫克除外)和托法替尼(10毫克,每日一次)均名列前茅。托法替尼(10 毫克,每日一次)被认为是最不安全的。根据疗效和安全性进行的排名分析表明,去氯法替尼(3 毫克 QD 和 3 毫克 BID)是最佳治疗方法。
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