Efficacy And Safety Of JAK Inhibitors In The Treatment Of Ulcerative Colitis:a Meta-analysis

Objective:To systematically evaluate the efficacy and safety of JAK inhibitors in the treatment of Ulcerative colitis(UC).Methods:RCTs on the efficacy of JAK inhibitors in the treatment of UC were systematically searched in the databases of China How Net,Pub Med,EMBASE and Cochrane Library,Languages include Chinese and English,The deadline for the database is December 2021,Extract the relevant data included in the study to collection,integration and analysis.And use revman5.3 software for meta-analysis,Q-test and I2 to evaluate the heterogeneity between the research groups,and decide to use fixed effect model or random model according to the heterogeneity.Results:Six articles were including ten randomized controlled studies,involved 4357 patients and including 3321 in the experimental group and 1036 in the control group.And different doses,different drug types and administration methodsof JAK inhibitor were compared with placebo.The results of meta-analysis were:1.Curative effect:(1)Induction period:The clinical response rate,clinical remission rate and endoscopic remission rate of JAK inhibitor in the treatment of UC were better than those in the placebo group[OR=3.41,95%CI:2.60～4.47,Z=8.88,P<0.00001,OR=2.65,95%CI:1.95～3.60,Z=6.27,P<0.00001,OR=2.49,95%CI:1.86～3.35,Z=6.09,P<0.00001].(2)Maintenance period:The clinical remission rate of JAK inhibitor in the treatment of UC was higher than that in the placebo group[OR=4.09,95%CI:2.81～5.96,Z=7.34,P<0.00].2.Safety:There was no significant difference in adverse reactions and serious adverse reaction ratebetween JAK inhibitor and placebo group during induction and maintenance period.3.The clinical remission rate of 10 mg tofatinib in the treatment of UC was higher than that in the placebo group[OR=4.16,95% CI:2.89～5.99,Z=7.69,P<0.00001],There was no significant difference in the adverse reaction rate of 10 mg tofatinib compared with placebo in the treatment of UC.Conclusion:JAK inhibitor is safe and effective in inducing and maintaining remission of Ulcerative colitis.