白癜风是由自身免疫反应引起的慢性皮肤病,导致黑素细胞的进行性丧失,最近的研究表明,Janus激酶抑制剂(JAKi)正在成为一种有前途的新治疗方式。因此,评估和了解JAKI在白癜风中使用的新兴领域的知识程度,对文献进行了范围审查。审查的文章探讨了各种JAKI口服或局部给药白癜风。没有研究可注射的JAKI。Tofacitinib是在选择进行审查的35项研究中的16项研究中最常用的口服JAKI。其次是巴利替尼(n=3),每个研究都使用了利替尼,鲁索替尼,和upadacitinib.Ruxolitinib(n=6)和tofacitinib(n=6)是最常研究的局部JAKI,其次是德戈西替尼(n=1)。根据JAKi的受体选择性谱和共存的自身免疫性疾病,它们之间的潜在益处可能有所不同。局部JAKI在有限的身体区域参与和青少年中是有利的。同时使用JAKI与光疗或阳光照射似乎是有益的。大多数研究允许使用其他局部药物。痤疮相关事件,虽然频繁但温和,据报道,口服和外用JAKI。鼻咽炎,上呼吸道感染,头痛是在使用JAKI的大型试验中最常见的不良反应.未检测到严重或有临床意义的血液学或血栓栓塞事件。口服或外用JAKI治疗白癜风似乎很有希望,越来越多的证据显示出有利的风险-收益特征。
Vitiligo is a chronic skin condition caused by an autoimmune response that results in the progressive loss of melanocytes and recent studies have suggested that Janus kinase inhibitors (JAKi) are emerging as a promising new treatment modality. Therefore, to assess and understand the extent of knowledge in the emerging field of JAKi use in vitiligo, a scoping review of the literature was undertaken. The reviewed articles explored a wide variety of JAKi administered either orally or topically for vitiligo. There were no injectable JAKi studied. Tofacitinib was the most commonly studied oral JAKi in 16 of the 35 studies selected for review, followed by baricitinib (n = 3), and one study each with ritlecitinib, ruxolitinib, and upadacitinib. Ruxolitinib (n = 6) and tofacitinib (n = 6) were the most often studied topical JAKi, followed by delgocitinib (n = 1). Potential benefits may vary between JAKi based on their receptor selectivity profile and coexistent autoimmune diseases. A topical JAKi would be advantageous in limited body area involvement and in adolescents. Concurrent use of JAKi with phototherapy or sun exposure appears beneficial. Most studies permitted the use of other topical agents. Acne-related events, though frequent yet mild, were reported with both oral and topical JAKi. Nasopharyngitis, upper respiratory tract infections, and headaches were the most common adverse effects seen in the larger trials with JAKi. No serious or clinically meaningful hematology or thromboembolic events were detected. Treatment of vitiligo with oral or topical JAKi seems to be promising and the growing evidence shows a favorable risk-benefit profile.