Efficacy of baricitinib in the treatment of Systemic lupus erythematosus (SLE): A Systemic review and meta-analysis

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease. It affects multiple organ systems and is associated with significant morbidity and mortality. The treatment for SLE primarily aims at controlling and remitting the disease. Baricitinib is a kinase inhibitor that selectively inhibits JAK1 and JAK2 enzymes. Recently this drug is being investigated as a potential therapeutic option for SLE. Objective: To analyze the efficacy of baricitinib in treating SLE. Methods: Search of databases identified relevant studies that reported the efficacy of baricitinib. Data of patient characteristics, intervention details, and outcomes was extracted. The data from the studies were pooled using a random-effects model. The odds ratio with their respective 95 % confidence intervals (CI) were calculated to analyze the results. A p value of <0.05 was considered statistically significant. Results: 3 RCTs were included in the analysis. 1849 patients were extracted from the included studies, most of the participants were females with a mean age of 43 years. The studies showed a significant effect of Baricitinib 4 mg in achieving SRI-4 [OR = 1.42 (95 % CI: 1.01, 2.00); p = 0.04]. There was no significant association of Baricitinib 2 mg in achieving SRI-4. Both dosages of the drug did not have any significant association in achieving LLDAS as compared to placebo. Serious adverse side effects were significantly associated with Bar 4 mg as compared to Bar 2 mg. Conclusion: Our meta-analysis suggests that baricitinib might be a potential treatment option for SLE. Further large-scale clinical trials are needed to confirm our findings. Potential side effects should also be considered while the administration of this drug.