Real-World Effectiveness and Safety of JAK Inhibitors in Atopic Dermatitis: A Systematic Review and Meta-Analysis

Abstract

Objective: The aim of this study is to evaluate the effectiveness and safety of JAK inhibitors in patients with moderate to severe atopic dermatitis by performing a systematic review and meta-analysis using data from studies in real-world settings. Design: Systematic review and meta-analysis. Pooled estimates for effectiveness and safety were assessed using the Freeman–Tukey Double ArcSine method. Statistical heterogeneity was assessed using I2 statistics. A random-effects model (DerSimonian-Laird method) was applied to consider the heterogeneity within and between studies and to give a more conservative estimate. The study quality assessment tools developed by the National Heart, Lung, and Blood Institute were used. Data Source: Relevant studies were searched in March 2025 using four databases: PubMed, Embase, Scopus, and Web of Science. Eligibility Criteria: Studies evaluating the effectiveness or safety of systemic JAK inhibitors among patients with moderate to severe atopic dermatitis in a real-world setting were included. Results: A total of 50 studies were included in this review. Regarding their effectiveness, the pooled estimates with a 95% CI of Eczema Area and Severity Index (EASI)-75 were 44% (34%–55%), 45% (28%–62%), 59% (51%–66%), 73% (64%–81%), 70% (57%–81%), and 86% (72%–96%) at 4, 8, 12, 16, 24, and 52 weeks. For safety, the most common adverse events were acne (16%), followed by increased creatine phosphokinase levels (13%) and increased lipids (12%). Conclusion: Our meta-analysis of JAK inhibitors in patients with atopic dermatitis demonstrated that the overall outcomes from real-world settings are comparable to those from clinical trials. Systematic Review Registration: Protocol Registration: PROSPERO CRD42024569258.