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SYSTEMATIC REVIEW article
Front. Pharmacol.
Sec. Inflammation Pharmacology
Volume 15 - 2024 |
doi: 10.3389/fphar.2024.1459511
Systematic review of Janus kinases inhibitors for rheumatoid arthritis: methodology, reporting, and quality of evidence evaluation
Provisionally accepted- 1 China Three Gorges University, Yichang, China
- 2 Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong Province, China
- 3 The First Clinical Medical College of China Three Gorges University, Yichang, Hubei Province, China
- 4 Second Hospital of Yichang, Yichang, Hubei Province, China
Objective: To evaluate the methodological, reporting and evidence quality of systematic reviews or meta-analyses of Janus kinases (JAK) inhibitors for the treatment of rheumatoid arthritis (RA).Methods: Our study systematically retrieved reviews from various databases, spanning from inception to June 2024. Two evaluators independently assessed the methodological, reporting, and evidence quality of each review using the AMSTAR-2 and PRIAMA2020 tools. The evidence quality was evaluated according to GRADE criteria. Six aspects were evaluated: publication year, study type, homogeneity, risk of publication bias, AMSTAR-2 methodology, and PRIAMA2020 reporting quality. Excel 2016 facilitated conversion of scores into radar plots.Results: Following stringent selection criteria, a total of 18 relevant studies were identified. The AMSTAR-2 scores ranged from 4 to 13 points, with 5 studies rated as low quality and the remaining 13 as critically low quality. All studies encompassed populations, interventions, controls, and outcome measures, demonstrating commendable integrity. However, there is room for improvement in study protocol development and registration, comprehensive search strategies, inclusion and exclusion criteria, conflict of interest disclosure, and discussion of heterogeneity. PRIAMA2020 assessments ranged from 14.5 to 21 points, with 2 studies scoring below 15 points due to increased bias risk from data transformation and sensitivity analysis. Notably, all reviews (100%) adhered to PRIAMA2020 guidelines for certain items but none met all criteria. GRADE evaluation included 446 outcome measures, with 158 of moderate, 156 of low, and 132 of very low quality, indicating JAK inhibitors is effective in improving RA. According to radar chart, the average rank score was 13.13.One study achieved a balanced score across all dimensions, while 11 exceeded the average, 5 showed significant differences in PRIAMA2020 scores, and 4 in AMSTAR 2 scores.Despite summarizing the efficacy and safety of JAK inhibitors in treating RA, the included studies exhibited poor methodological and reporting quality, along with low-quality evidence overall. Therefore, caution is warranted among decision-makers regarding the use of JAK inhibitors in RA treatment. Urgent requirements include high-quality, multicenter studies investigating JAK inhibitors for RA.
Keywords: JAK inhibitors, Rheumatoid arthritis, AMSTAR-2, PRIAMA2020-2020, GRADE system
Received: 04 Jul 2024; Accepted: 10 Sep 2024.
Copyright: © 2024 Xiaolan, Xiaoman, Xiang, Xiaoqiang, Huang and Feng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zhitao Feng, China Three Gorges University, Yichang, China
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