Background

Janus kinase inhibitors (JAKi) have attracted attention for their role in treating inflammatory disorders. This new class of biologics has the potential to significantly impact the field of dermatology, especially with the development of topical formulations.

Objective

To summarize published evidence on the efficacy, safety, and tolerability of topical JAKi in the treatment of inflammatory skin conditions.

Methods

This is a review of PubMed and Cochrane Library up until November 2017.

Results

Fifty-five potential articles were identified; 11 articles were included for review, comprising an aggregate 924 patients. In randomized clinical trials (RCTs), topical JAKi demonstrate modest improvements in psoriasis and atopic dermatitis disease scores, patient-reported outcomes, and quality of life. Results for vitiligo are conflicting, with improvements seen only in facial vitiligo. Conclusive efficacy data for alopecia areata is lacking.

Limitations

It was not possible to perform a meta-analysis due to lack of standardization and low number of RCTs.

Conclusions

Topical JAKi provide an attractive treatment option for patients with psoriasis, atopic dermatitis, alopecia areata, and vitiligo. Although early phase clinical studies of this novel drug class are promising, large phase 3 and 4 studies are needed to further define the role of topical JAKi in dermatology.

中文翻译：

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局部Janus激酶抑制剂：在皮肤病学中的应用综述。

背景

Janus激酶抑制剂（JAKi）在治疗炎症性疾病中的作用引起了人们的关注。这类新型的生物制剂具有极大地影响皮肤病学领域的潜力，尤其是随着局部制剂的发展。

客观的

总结关于局部JAKi在治疗炎症性皮肤疾病中的功效，安全性和耐受性的公开证据。

方法

这是对PubMed和Cochrane图书馆截至2017年11月的评论。

结果

确定了55篇潜在文章；纳入11篇文章进行回顾，总共924例患者。在随机临床试验（RCT）中，局部JAKi表现出牛皮癣和特应性皮炎疾病评分，患者报告的结局和生活质量的适度改善。白癜风的结果是矛盾的，只有面部白癜风才有改善。缺乏关于斑秃的确切疗效数据。

局限性

由于缺乏标准化和RCT数量少，无法进行荟萃分析。

结论

外用JAKi为牛皮癣，特应性皮炎，斑秃和白癜风患者提供有吸引力的治疗选择。尽管这种新型药物的早期临床研究前景广阔，但仍需要进行大型3期和4期研究以进一步确定局部JAKi在皮肤病学中的作用。