Efficacy and safety of tofacitinib for moderate‐to‐severe plaque psoriasis: a systematic review and meta‐analysis of randomized controlled trials

摘要

Abstract The effects of tofacitinib in treating moderate‐to‐severe plaque psoriasis were unclear. We aimed to assess the effects of tofacitinib in treating moderate‐to‐severe plaque psoriasis. We searched PubMed, Cochrane Central Register of Controlled Trials and EMBASE for relevant randomized controlled trials ( RCT s) and conducted a systematic review and meta‐analysis. Four RCT s with 2724 participants were included. Compared to placebo, tofacitinib significantly improved psoriasis {≥75% reduction in the Psoriasis Area and Severity Index score: 5 mg BID : risk difference ( RD ) 0.32 [95% confidence interval ( CI ) 0.28–0.35], 10 mg BID : RD 0.51 (95% CI 0.43–0.58); ≥90% reduction in the Psoriasis Area and Severity Index score: 5 mg BID : RD 0.19 (95% CI 0.17–0.22), 10 mg BID : RD 0.36 (95% CI 0.31–0.42); Physician's Global Assessment 0/1: 5 mg BID : RD 0.31 (95% CI 0.27–0.35), 10 mg BID : RD 0.48 (95% CI 0.44–0.53)} and participants’ life quality [Dermatology Life Quality Index 0/1: 5 mg BID : RD 0.24 (95% CI 0.20–0.2), 10 mg BID : RD 0.36 (95% CI 0.33–0.40)]. Tofacitinib was associated with an increase in minor adverse events [upper respiratory tract infection: 5 mg BID : RD 0.02 (95% CI 0.00–0.03), 10 mg BID : RD 0.02 (95% CI 0.00–0.04); hypercholesterolaemia: 5 mg BID : RD 0.02 (95% CI 0.01–0.04), 10 mg BID : RD 0.02 (95% CI 0.01–0.04)]. In conclusion, tofacitinib may be a treatment option for moderate‐to‐severe plaque psoriasis that is unresponsive to other therapies and patients who are intolerable to other therapies or prefer oral medications.