Tesis

Janus Kinase (JAK)-inhibitor dan Mortalitas Coronavirus Disease 2019 (Covid-19) : Telaah Sistematis dan Metaanalisis = Janus Kinase (JAK)-inhibitors and coronavirus disease 2019 (Covid-19) mortality: A systematic review and meta-analysis.

Latar Belakang: Janus Kinase (JAK)-inhibitors telah digunakan untuk terapi beberapa penyakit inflamasi dan autoimun karena kemampuannya untuk mengendalikan respon imun dan cytokine release syndrome. Saat ini penggunaan baru dari Janus Kinase (JAK)-inhibitors diperuntukan untuk terapi coronavirus disease 2019 (Covid-19), namun bukti mengenai kegunaannya masih belum jelas. Penelitian ini dilakukan untuk menganalisa efikasi dari Janus Kinase (JAK)inhibitors untuk mengurangi mortalitas pasien Covid-19. Tujuan: Mengetahui efek pemberian terapi Janus Kinase (JAK)-inhibitors terhadap mortalitas pasien Covid-19. Metode: Dengan menggunakan kata kunci spesifik, dilakukan pencarian artikel potensial secara komprehensif pada PubMed, Europe PMC, and ClinicalTrials.gov database dengan pembatasan waktu sampai 2 Juni 2021. Semua penelitian tentang Covid-19 dan JAK-inhibitors dimasukan. Analisa statistik dilakukan dengan Review Manager 5.4 software. Hasil: 13 penelitian dengan 4339 pasien Covid-19 dimasukan dalam meta-analisis. Data kami menyimpulkan bahwa terapi JAK-inhibitors berhubungan dengan menurunnya mortalitas pasien Covid-19 (RR 0.52; 95%CI: 0.36 – 0.76, p=0.0006, I 2 = 33%, random-effect modelling). Kesimpulan: Penelitian ini menyimpulkan terapi JAK-inhibitors berhubungan dengan menurunnya mortalitas pasien Covid-19. Namun dibutuhkan randomized clinical trials yang lebih banyak untuk mengkonfirmasi hasil penelitian ini.
Kata kunci: coronavirus disease 2019; Covid-19; JAK-inhibitors; baricitinib; terapi


Background: : Janus Kinase (JAK)-inhibitors have been used for treating several inflammatory and autoimmune disease because of its ability to restrains immune systems and cytokine release syndrome. Currently, JAK-inhibitors are repurposed for the treatment of coronavirus disease 2019 (Covid-19), however the evidence regarding their benefit are still unclear. This study sought to analyze the efficacy of JAK-inhibitors in improving the mortality outcomes of Covid-19 patients. Objective: To determine the effect of JAK-inhibitors as therapy in Covid-19 patients related to mortality. Methods: Using specific keywords, we comprehensively searched the potential articles on PubMed, Europe PMC, and ClinicalTrials.gov database until June 2 nd , 2021. All published studies on Covid-19 and JAK-inhibitors were retrieved. Statistical analysis was conducted using Review Manager 5.4 software. Results: A total of 13 studies with 4,339 Covid-19 patients were included in the meta-analysis. Our data suggested that JAK-inhibitors was associated with reduction of mortality from Covid-19 (RR 0.52; 95%CI: 0.36 – 0.76, p=0.0006, I 2 = 33%, random-effect modelling). Conclusion: Our study suggests that JAK-inhibitors may offer beneficial effects on Covid-19 mortality. However, more randomized clinical trials warrant to confirm the findings of our study.
Keywords: coronavirus disease 2019; Covid-19; JAK-inhibitors; baricitinib; treatment