Effects of Janus kinase inhibitors in adults admitted to hospital due to COVID-19: a systematic review and individual participant data meta-analysis of randomised clinical trials

作者：Alain Amstutz, Stefan Schandelmaier, Hannah Ewald, Benjamin Speich, Johannes M. Schwenke, Christof M Schönenberger, Stephan Schobinger, Thomas Agoritsas, Kay M. Tomashek, Seema Nayak, Mat Makowski, Alejandro Morales‐Ortega, David Bello, Giovanni Pomponio, Alessia Ferrarini, Monireh Ghazaeian, Frances Hall, Simon Bond, María Teresa García-Morales, María Jiménez-González, José Ramón Arribas, Patricia O Guimaraães, Caio de Assis Moura Tavares, Otávio Berwanger, Yazdan Yazdanpanah, Victoria Charlotte Simensen, Karine Lacombe, Maya Hites, Florence Ader, Evelina Tacconelli, France Mentré, Drifa Belhadi, Clément Massonnaud, Cédric Laouenan, Alpha Diallo, Aliou Baldé, Lambert Assoumou, Dominique Costagliola, Erica Ponzi, Corina S. Rueegg, Inge Christoffer Olsen, Marius Trøseid, Matthias Briel · 发表于：The Lancet Respiratory Medicine · 年份：2025 · DOI：10.1016/s2213-2600(25)00055-4 · 被引用次数：11 · 研究领域：Long-Term Effects of COVID-19、Cytokine Signaling Pathways and Interactions、COVID-19 Clinical Research Studies

BACKGROUND: Evidence from randomised clinical trials (RCTs) of Janus kinase (JAK) inhibitors-compared with usual care or placebo-in adults treated in hospital for COVID-19 is conflicting. We aimed to evaluate the benefits and harms of JAK inhibitors compared with placebo or usual care and whether treatment effects differed between prespecified participant subgroups. METHODS: For this systematic review and individual participant data meta-analysis (IPDMA), we searched Medline via Ovid, Embase via Elsevier, the Cochrane Central Register of Controlled Trials, the Cochrane COVID-19 Study Register, and the COVID-19 L·OVE Platform, including backward and forward citation searching (last search Nov 28, 2024), for RCTs (unpublished or published in any format and any language) that randomly assigned adults (aged ≥16 years) admitted to a hospital due to COVID-19 to receive either a JAK inhibitor (any type) or no JAK inhibitor (ie, received site-specific standard of care with or without placebo), and requested individual participant data (IPD) from the original trial teams. The primary outcome was all-cause mortality at day 28 after random assignment. We used two-stage meta-analyses adjusting for age and respiratory support, and pooled estimates using random-effects models. The assessment of individual-level effect modifiers was based solely on within-trial information and continuous modifiers were investigated as both linear and non-linear interactions. We used the Instrument for Asses...