A systematic review of Janus kinase inhibitors and spleen tyrosine kinase inhibitors for Hidradenitis suppurativa treatment

Int Immunopharmacol. 2024 Jan 25:127:111435. doi: 10.1016/j.intimp.2023.111435. Epub 2023 Dec 26.

Abstract

Backgrounds and aims: Hidradenitis suppurativa (HS) is a challenging skin disease with an underlying inflammatory process. Substantial progress has been made in our understanding of HS over the last few years, with the advancement of novel treatment approaches. The current systematic review aims to evaluate the safety and efficacy of Janus kinase (JAK) inhibitors and spleen tyrosine kinase (Syk) inhibitors in treating HS.

Method: A thorough systematic search was performed on PubMed/Medline, Web of Science, and Ovid Embase databases up to September 23th, 2023. Clinical studies published in English were included.

Results: Our search yielded ten articles with a total of 165 patients treated with four types of JAK inhibitors (upadacitinib, povorcitinib, tofacitinib, and baricitinib) and one Syk inhibitor (fostamatinib). Upadacitinib, povorcitinib, and tofacitinib improved clinical outcomes, with a significant reduction in hidradenitis suppurativa clinical response (HiSCR) and abscess and inflammatory nodule count (AN count) during the treatment period. Also, these drugs are well tolerated in most HS patients with minimal adverse events (AEs). Moreover, baricitinib depicted an amelioration in signs and symptoms of HS in one case report. Also, fostamatinib exhibited favorable tolerability throughout a 12-week in moderate-to-severe HS patients. The remarkable clinical improvement, as assessed through HiSCR and hidradenitis suppurativa severity (IHS4), corresponded closely with serological indicators of inflammation following fostamatinib administration was achieved.

Conclusion: JAK and Syk inhibitors are potentially efficacious in managing moderate-to-severe HS since the proinflammatory cytokines are mediated by JAK and Syk signaling pathways. However, further research with a more rigorous examination is mandatory to evaluate such medication's long-term safety and efficacy.

Keywords: HS; Hidradenitis suppurativa; JAK inhibitor; Janus kinase inhibitor; Spleen tyrosine kinase inhibitor; Syk inhibitor.

Publication types

  • Systematic Review
  • Case Reports
  • Review

MeSH terms

  • Adalimumab / therapeutic use
  • Aminopyridines*
  • Azetidines*
  • Hidradenitis Suppurativa* / diagnosis
  • Hidradenitis Suppurativa* / drug therapy
  • Humans
  • Janus Kinase Inhibitors* / therapeutic use
  • Morpholines*
  • Purines*
  • Pyrazoles*
  • Pyrimidines*
  • Severity of Illness Index
  • Spleen
  • Sulfonamides*
  • Syk Kinase
  • Treatment Outcome
  • Tyrosine Kinase Inhibitors

Substances

  • fostamatinib
  • baricitinib
  • Adalimumab
  • Janus Kinase Inhibitors
  • Tyrosine Kinase Inhibitors
  • Syk Kinase
  • Aminopyridines
  • Pyrazoles
  • Sulfonamides
  • Azetidines
  • Purines
  • Pyrimidines
  • Morpholines