白癜风,一种自身免疫性疾病,其特征是由于功能性黑素细胞的丧失而导致的皮肤斑点褪色,与JAK-STAT信号通路的失调有关,特别是在IFN-g信号传导中。JAK抑制剂的使用,如鲁索替尼乳膏,JAK1和JAK2抑制剂,提出了一种有希望的白癜风治疗方法。本研究旨在系统评估鲁索利替尼乳膏在白癜风患者中的有效性和安全性。我们遵循PRISMA指南进行了系统评价和荟萃分析,以评估鲁索利替尼乳膏治疗白癜风的有效性和安全性。全面搜索PubMed,谷歌学者,和CochraneLibrary数据库用于随机对照试验(RCTs)。数据选择,筛选,提取,并对偏倚风险进行了细致的评估.使用ReviewManager软件进行统计分析,版本5.4,通过适当的方法解决了显著的异质性。我们的荟萃分析包括3项研究,包括830例白癜风患者。在F-VASI中观察到显着改善,T-VASI,F-BSA,和T-BSA评分,与12周相比,24周时的疗效更高[MD-24.17,95%CI(-31.78至-16.56),P<0.00001],[MD-14.12,95%CI(-20.54至-7.70);P<0.0000],[MD-16.25,95%CI(-22.20至-10.31),P<0.00001],[MD-9.19,95%CI(-13.47至-4.92);P<0.00001]。Ruxolitinib显示F-VASI75,F-VASI90和F-VASI50的风险比增加,表明治疗持续时间更长的结果更好[MD2.9,95%CI1.88-4.49;P<0.00001],[MD4.66,95%CI2.09-10.39;P=0.0002],[MD2.53,95%CI1.84-3.46;P<0.00001]。轻度和中度不良事件无显著差异,而严重病例则倾向于鲁索替尼。安慰剂在任何不良事件中都有显著优势,与药物相关的不良事件没有显着差异。两组之间的严重不良事件没有显着差异。研究结果强烈支持鲁索替尼治疗随着时间的推移改善各种参数治疗白癜风的疗效。然而,全面考虑其安全性,特别是关于不良事件和潜在的副作用,是有保证的。需要更大样本量的进一步研究来证实这些结论。
Vitiligo, an autoimmune condition characterized by depigmented skin patches due to the loss of functional melanocytes, has been linked to dysregulation in the JAK-STAT signaling pathway, particularly in IFN-g signaling. The use of JAK inhibitors, such as
ruxolitinib cream, a JAK1 and JAK2 inhibitor, presents a promising approach for vitiligo treatment. This study aims to systematically assess the effectiveness and safety of
ruxolitinib cream in patients with vitiligo. We conducted a systematic review and meta-analysis following PRISMA guidelines to evaluate the efficacy and safety of
ruxolitinib cream for the treatment of vitiligo. A comprehensive search of PubMed, Google Scholar, and Cochrane Library databases for randomized controlled trials (RCTs). Data selection, screening, extraction, and risk of bias assessment were meticulously performed. Statistical analysis was conducted using Review Manager Software, version 5.4, with significant heterogeneity addressed through appropriate methods. Our meta-analysis included 3 studies with 830 vitiligo patients. Significant improvements were observed in F-VASI, T-VASI, F-BSA, and T-BSA scores, with greater efficacy at 24 weeks compared to 12 weeks [MD -24.17, 95% CI (-31.78 to -16.56), P < 0.00001], [MD -14.12, 95% CI (-20.54 to -7.70); P < 0.0000], [MD -16.25, 95% CI (-22.20 to -10.31), P < 0.00001], [MD -9.19, 95% CI (-13.47 to -4.92); P < 0.00001].
Ruxolitinib showed increased risk ratios for F-VASI75, F-VASI90, and F-VASI50, indicating better outcomes with longer treatment durations [MD 2.9, 95% CI 1.88-4.49; P < 0.00001], [MD 4.66, 95% CI 2.09-10.39; P = 0.0002], [MD 2.53, 95% CI 1.84-3.46; P < 0.00001]. No significant differences were found in mild and moderate adverse events, while severe cases favored ruxolitinib. Placebo had a significant advantage in any adverse events, with no significant difference in drug-related adverse events. Serious adverse events did not significantly differ between groups. The findings strongly support the efficacy of
ruxolitinib therapy in improving various parameters over time for treating vitiligo. However, thorough consideration of its safety profile, particularly concerning adverse events and potential side effects, is warranted. Further studies with larger sample sizes are needed to confirm these conclusions.