Age-Stratified Analysis of Acne as an Adverse Event in Patients Treated with Janus Kinase Inhibitors: A Systematic Review and Meta-Analysis

There are many medical conditions caused by inflammation such as rheumatoid arthritis (joint inflammation), psoriatic arthritis (joint swelling with skin issues), COVID-19 and alopecia areata (hair loss). In inflammatory conditions the body produces excess proteins which cause an overreaction in the immune response triggering swelling and pain.

Janus kinase inhibitors have been recently approved by the US Food and Drug Administration (FDA) and are widely used in the treatment of patients with a variety of inflammatory conditions such as those listed above. Janus kinase (JAK) inhibitors work by tamping down an overactive immune system. Janus kinase inhibitors, such as upadacitinib and abrocitinib, have recently been approved by the FDA and are increasingly being used in the treatment of atopic dermatitis (a common form of eczema, a condition that causes the skin to become itchy, dry and cracked). Despite the promising efficacy of Janus kinase inhibitors in treating inflammatory conditions, the emergence of acne, a skin condition resulting from the blockage of hair follicles by oil and dead skin cells, has been consistently reported as an adverse effect in clinical trials involving these inhibitors.

A systematic review is a thorough summary of all available research on a specific topic, using clear and structured methods to find answers. A meta-analysis is a part of this process where data from several studies are combined and analyzed statistically to draw more accurate conclusions.

Recent meta-analysis of randomized controlled trials on Janus kinase inhibitors revealed an increased likelihood of acne, regardless of the specific type of medication used. However, the paper did not conduct subgroup analysis based on age. Given the notable prevalence of acne among adolescents in clinical settings, there is an urgent need for clinical guidelines addressing the risk of acne associated with different types of JAK inhibitor use.

This research will employ a systematic review and meta-analysis to investigate the adverse effect of acne associated with Janus kinase inhibitors and enhance patient care. The systematic review will identify relevant randomized controlled trials, focusing on the adverse effect of acne. Meta-analysis will be performed to assess the increased likelihood of acne with Janus kinase inhibitors. Given the notable prevalence of acne among adolescents, a subgroup analysis based on age will be conducted to identify age-related patterns in the occurrence of acne.

The identification of an increased likelihood of acne, especially among adolescents, emphasizes the need for tailored clinical guidelines. Developing guidelines for managing acne associated with different types of JAK inhibitors will assist healthcare professionals in mitigating this side effect effectively, ultimately improving patient care.