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.