Janus Kinase inhibitors in the treatment of large vessel vasculitis: a systematic review and meta-analysis

Objectives: This meta-analysis evaluates Janus Kinase (JAK) inhibitors' efficacy and safety in large vessel vasculitis (LVV), encompassing Giant Cell Arteritis (GCA) and Takayasu's Arteritis (TAK). Methods: Registered on PROSPERO (CRD42024575313), four databases were systematically searched for randomized controlled trials (RCTs) and observational studies. Outcomes included remission/relapse rates and adverse events, assessed with sensitivity/publication bias analyses. Results: Five studies (107 patients: 65 GCA, 42 TAK) showed pooled 12-month remission rates of 80.1 % (95 % CI: 68.3-92.0), with subgroup rates of 87.3 % (GCA) and 69.6 % (TAK). Relapse rates were 11.3 % overall (2.5 % GCA vs. 22.9 % TAK). Adverse event-related discontinuation was 4.4 %, with subgroup rates of 4.0 % (GCA) and 4.2 % (TAK). Conclusions: JAK inhibitors demonstrate favorable efficacy and safety in LVV.