A meta-analysis of therapeutic trials of topical ruxolitinib cream for the treatment of vitiligo: therapeutic efficacy, safety, and implications for therapeutic practice
Vitiligo, an autoimmune condition characterized by depigmented skin patches due to the loss of functional melanocytes, has been linked to dysregulation in the JAK-STAT signaling pathway, particularly in IFN-g signaling. The use of JAK inhibitors, such as ruxolitinib cream, a JAK1 and JAK2 inhibitor,...
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| Veröffentlicht in: | Archives of dermatological research 2024-08, Vol.316 (8), p.518, Article 518 |
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| creator | Hussein, Abbas F. Abdul Shams, Ahmed S. Hosny, Nora Elrosasy, Amr Kobtan, Marwan Shafik, Yasmin Ahmed Alnatsheh, Zeinab Raed Zeid, Mohamed Abo Qarma, Mugahed Ibrahim, Yathrib K. Al-Sultany, Hussein Abbas |
| description | Vitiligo, an autoimmune condition characterized by depigmented skin patches due to the loss of functional melanocytes, has been linked to dysregulation in the JAK-STAT signaling pathway, particularly in IFN-g signaling. The use of JAK inhibitors, such as ruxolitinib cream, a JAK1 and JAK2 inhibitor, presents a promising approach for vitiligo treatment. This study aims to systematically assess the effectiveness and safety of ruxolitinib cream in patients with vitiligo. We conducted a systematic review and meta-analysis following PRISMA guidelines to evaluate the efficacy and safety of ruxolitinib cream for the treatment of vitiligo. A comprehensive search of PubMed, Google Scholar, and Cochrane Library databases for randomized controlled trials (RCTs). Data selection, screening, extraction, and risk of bias assessment were meticulously performed. Statistical analysis was conducted using Review Manager Software, version 5.4, with significant heterogeneity addressed through appropriate methods. Our meta-analysis included 3 studies with 830 vitiligo patients. Significant improvements were observed in F-VASI, T-VASI, F-BSA, and T-BSA scores, with greater efficacy at 24 weeks compared to 12 weeks [MD –24.17, 95% CI (–31.78 to –16.56), P |
| doi_str_mv | 10.1007/s00403-024-03267-8 |
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P
< 0.00001], [MD –9.19, 95% CI (–13.47 to –4.92); P < 0.00001]. Ruxolitinib showed increased risk ratios for F-VASI75, F-VASI90, and F-VASI50, indicating better outcomes with longer treatment durations [MD 2.9, 95% CI 1.88–4.49; P < 0.00001], [MD 4.66, 95% CI 2.09–10.39; P = 0.0002], [MD 2.53, 95% CI 1.84–3.46; P < 0.00001]. No significant differences were found in mild and moderate adverse events, while severe cases favored ruxolitinib. Placebo had a significant advantage in any adverse events, with no significant difference in drug-related adverse events. Serious adverse events did not significantly differ between groups. The findings strongly support the efficacy of ruxolitinib therapy in improving various parameters over time for treating vitiligo. However, thorough consideration of its safety profile, particularly concerning adverse events and potential side effects, is warranted. Further studies with larger sample sizes are needed to confirm these conclusions.]]></description><identifier>ISSN: 1432-069X</identifier><identifier>ISSN: 0340-3696</identifier><identifier>EISSN: 1432-069X</identifier><identifier>DOI: 10.1007/s00403-024-03267-8</identifier><identifier>PMID: 39134884</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adverse events ; Autoimmune diseases ; Clinical trials ; Dermatology ; Humans ; Inhibitor drugs ; Janus kinase ; Janus kinase 2 ; Janus Kinase Inhibitors - administration & dosage ; Janus Kinase Inhibitors - adverse effects ; Janus Kinase Inhibitors - therapeutic use ; Medicine ; Medicine & Public Health ; Melanocytes ; Meta-analysis ; Nitriles ; Pyrazoles - administration & dosage ; Pyrazoles - adverse effects ; Pyrazoles - therapeutic use ; Pyrimidines - administration & dosage ; Pyrimidines - therapeutic use ; Randomized Controlled Trials as Topic ; Review ; Side effects ; Signal transduction ; Skin Cream - administration & dosage ; Statistical analysis ; Topical medication ; Treatment Outcome ; Vitiligo ; Vitiligo - drug therapy</subject><ispartof>Archives of dermatological research, 2024-08, Vol.316 (8), p.518, Article 518</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c256t-f4f548acdf291bdab082ef6d0f7c1774dc99387f2e6a07d83f6ddf92662d26473</cites><orcidid>0000-0002-4318-1329</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00403-024-03267-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00403-024-03267-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39134884$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hussein, Abbas F. Abdul</creatorcontrib><creatorcontrib>Shams, Ahmed S.</creatorcontrib><creatorcontrib>Hosny, Nora</creatorcontrib><creatorcontrib>Elrosasy, Amr</creatorcontrib><creatorcontrib>Kobtan, Marwan</creatorcontrib><creatorcontrib>Shafik, Yasmin Ahmed</creatorcontrib><creatorcontrib>Alnatsheh, Zeinab Raed</creatorcontrib><creatorcontrib>Zeid, Mohamed Abo</creatorcontrib><creatorcontrib>Qarma, Mugahed</creatorcontrib><creatorcontrib>Ibrahim, Yathrib K.</creatorcontrib><creatorcontrib>Al-Sultany, Hussein Abbas</creatorcontrib><title>A meta-analysis of therapeutic trials of topical ruxolitinib cream for the treatment of vitiligo: therapeutic efficacy, safety, and implications for therapeutic practice</title><title>Archives of dermatological research</title><addtitle>Arch Dermatol Res</addtitle><addtitle>Arch Dermatol Res</addtitle><description><![CDATA[Vitiligo, an autoimmune condition characterized by depigmented skin patches due to the loss of functional melanocytes, has been linked to dysregulation in the JAK-STAT signaling pathway, particularly in IFN-g signaling. The use of JAK inhibitors, such as ruxolitinib cream, a JAK1 and JAK2 inhibitor, presents a promising approach for vitiligo treatment. This study aims to systematically assess the effectiveness and safety of ruxolitinib cream in patients with vitiligo. We conducted a systematic review and meta-analysis following PRISMA guidelines to evaluate the efficacy and safety of ruxolitinib cream for the treatment of vitiligo. A comprehensive search of PubMed, Google Scholar, and Cochrane Library databases for randomized controlled trials (RCTs). Data selection, screening, extraction, and risk of bias assessment were meticulously performed. Statistical analysis was conducted using Review Manager Software, version 5.4, with significant heterogeneity addressed through appropriate methods. Our meta-analysis included 3 studies with 830 vitiligo patients. Significant improvements were observed in F-VASI, T-VASI, F-BSA, and T-BSA scores, with greater efficacy at 24 weeks compared to 12 weeks [MD –24.17, 95% CI (–31.78 to –16.56), P < 0.00001], [MD –14.12, 95% CI (–20.54 to –7.70); P < 0.0000], [MD –16.25, 95% CI (–22.20 to –10.31),
P
< 0.00001], [MD –9.19, 95% CI (–13.47 to –4.92); P < 0.00001]. Ruxolitinib showed increased risk ratios for F-VASI75, F-VASI90, and F-VASI50, indicating better outcomes with longer treatment durations [MD 2.9, 95% CI 1.88–4.49; P < 0.00001], [MD 4.66, 95% CI 2.09–10.39; P = 0.0002], [MD 2.53, 95% CI 1.84–3.46; P < 0.00001]. No significant differences were found in mild and moderate adverse events, while severe cases favored ruxolitinib. Placebo had a significant advantage in any adverse events, with no significant difference in drug-related adverse events. Serious adverse events did not significantly differ between groups. The findings strongly support the efficacy of ruxolitinib therapy in improving various parameters over time for treating vitiligo. However, thorough consideration of its safety profile, particularly concerning adverse events and potential side effects, is warranted. Further studies with larger sample sizes are needed to confirm these conclusions.]]></description><subject>Adverse events</subject><subject>Autoimmune diseases</subject><subject>Clinical trials</subject><subject>Dermatology</subject><subject>Humans</subject><subject>Inhibitor drugs</subject><subject>Janus kinase</subject><subject>Janus kinase 2</subject><subject>Janus Kinase Inhibitors - administration & dosage</subject><subject>Janus Kinase Inhibitors - adverse effects</subject><subject>Janus Kinase Inhibitors - therapeutic use</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Melanocytes</subject><subject>Meta-analysis</subject><subject>Nitriles</subject><subject>Pyrazoles - administration & dosage</subject><subject>Pyrazoles - adverse effects</subject><subject>Pyrazoles - therapeutic use</subject><subject>Pyrimidines - administration & dosage</subject><subject>Pyrimidines - therapeutic use</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Review</subject><subject>Side effects</subject><subject>Signal transduction</subject><subject>Skin Cream - administration & dosage</subject><subject>Statistical analysis</subject><subject>Topical medication</subject><subject>Treatment Outcome</subject><subject>Vitiligo</subject><subject>Vitiligo - drug therapy</subject><issn>1432-069X</issn><issn>0340-3696</issn><issn>1432-069X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9PHSEUxUnTpv5pv0AXDUk3LjqVAQTGnTHWNjFxY5PuCA8uFjMzjMAY30fqtyzPeVrtoqtD7v2dA-Eg9KElX1pC5GEmhBPWEMobwqiQjXqFdlvOaENE9_P1s_MO2sv5hlSTVO1btMO6lnGl-C76fYIHKKYxo-nXOWQcPS6_IJkJ5hIsLimYfpnGKVjT4zTfxz6UMIYVtgnMgH1MG09lwZQBxrLB7yrSh-t4_CIOvK8hdv0ZZ-OhVDWjw2GY-jouIY75Me3JMiVjq8I79MbXp8D7re6jH1_Prk6_NReX599PTy4aS49EaTz3R1wZ6zzt2pUzK6IoeOGIl7aVkjvbdUxJT0EYIp1ided8R4Wgjgou2T46WHKnFG9nyEUPIVvoezNCnLNmpKNMSMp4RT_9g97EOdWf3FJcEkorRRfKpphzAq-nFAaT1rolelOkXorUtUj9UKRW1fRxGz2vBnBPlsfmKsAWINfVeA3p793_if0Dla6s1w</recordid><startdate>20240812</startdate><enddate>20240812</enddate><creator>Hussein, Abbas F. Abdul</creator><creator>Shams, Ahmed S.</creator><creator>Hosny, Nora</creator><creator>Elrosasy, Amr</creator><creator>Kobtan, Marwan</creator><creator>Shafik, Yasmin Ahmed</creator><creator>Alnatsheh, Zeinab Raed</creator><creator>Zeid, Mohamed Abo</creator><creator>Qarma, Mugahed</creator><creator>Ibrahim, Yathrib K.</creator><creator>Al-Sultany, Hussein Abbas</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4318-1329</orcidid></search><sort><creationdate>20240812</creationdate><title>A meta-analysis of therapeutic trials of topical ruxolitinib cream for the treatment of vitiligo: therapeutic efficacy, safety, and implications for therapeutic practice</title><author>Hussein, Abbas F. Abdul ; Shams, Ahmed S. ; Hosny, Nora ; Elrosasy, Amr ; Kobtan, Marwan ; Shafik, Yasmin Ahmed ; Alnatsheh, Zeinab Raed ; Zeid, Mohamed Abo ; Qarma, Mugahed ; Ibrahim, Yathrib K. ; Al-Sultany, Hussein Abbas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c256t-f4f548acdf291bdab082ef6d0f7c1774dc99387f2e6a07d83f6ddf92662d26473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adverse events</topic><topic>Autoimmune diseases</topic><topic>Clinical trials</topic><topic>Dermatology</topic><topic>Humans</topic><topic>Inhibitor drugs</topic><topic>Janus kinase</topic><topic>Janus kinase 2</topic><topic>Janus Kinase Inhibitors - administration & dosage</topic><topic>Janus Kinase Inhibitors - adverse effects</topic><topic>Janus Kinase Inhibitors - therapeutic use</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Melanocytes</topic><topic>Meta-analysis</topic><topic>Nitriles</topic><topic>Pyrazoles - administration & dosage</topic><topic>Pyrazoles - adverse effects</topic><topic>Pyrazoles - therapeutic use</topic><topic>Pyrimidines - administration & dosage</topic><topic>Pyrimidines - therapeutic use</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Review</topic><topic>Side effects</topic><topic>Signal transduction</topic><topic>Skin Cream - administration & dosage</topic><topic>Statistical analysis</topic><topic>Topical medication</topic><topic>Treatment Outcome</topic><topic>Vitiligo</topic><topic>Vitiligo - drug therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hussein, Abbas F. Abdul</creatorcontrib><creatorcontrib>Shams, Ahmed S.</creatorcontrib><creatorcontrib>Hosny, Nora</creatorcontrib><creatorcontrib>Elrosasy, Amr</creatorcontrib><creatorcontrib>Kobtan, Marwan</creatorcontrib><creatorcontrib>Shafik, Yasmin Ahmed</creatorcontrib><creatorcontrib>Alnatsheh, Zeinab Raed</creatorcontrib><creatorcontrib>Zeid, Mohamed Abo</creatorcontrib><creatorcontrib>Qarma, Mugahed</creatorcontrib><creatorcontrib>Ibrahim, Yathrib K.</creatorcontrib><creatorcontrib>Al-Sultany, Hussein Abbas</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of dermatological research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hussein, Abbas F. Abdul</au><au>Shams, Ahmed S.</au><au>Hosny, Nora</au><au>Elrosasy, Amr</au><au>Kobtan, Marwan</au><au>Shafik, Yasmin Ahmed</au><au>Alnatsheh, Zeinab Raed</au><au>Zeid, Mohamed Abo</au><au>Qarma, Mugahed</au><au>Ibrahim, Yathrib K.</au><au>Al-Sultany, Hussein Abbas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A meta-analysis of therapeutic trials of topical ruxolitinib cream for the treatment of vitiligo: therapeutic efficacy, safety, and implications for therapeutic practice</atitle><jtitle>Archives of dermatological research</jtitle><stitle>Arch Dermatol Res</stitle><addtitle>Arch Dermatol Res</addtitle><date>2024-08-12</date><risdate>2024</risdate><volume>316</volume><issue>8</issue><spage>518</spage><pages>518-</pages><artnum>518</artnum><issn>1432-069X</issn><issn>0340-3696</issn><eissn>1432-069X</eissn><abstract><![CDATA[Vitiligo, an autoimmune condition characterized by depigmented skin patches due to the loss of functional melanocytes, has been linked to dysregulation in the JAK-STAT signaling pathway, particularly in IFN-g signaling. The use of JAK inhibitors, such as ruxolitinib cream, a JAK1 and JAK2 inhibitor, presents a promising approach for vitiligo treatment. This study aims to systematically assess the effectiveness and safety of ruxolitinib cream in patients with vitiligo. We conducted a systematic review and meta-analysis following PRISMA guidelines to evaluate the efficacy and safety of ruxolitinib cream for the treatment of vitiligo. A comprehensive search of PubMed, Google Scholar, and Cochrane Library databases for randomized controlled trials (RCTs). Data selection, screening, extraction, and risk of bias assessment were meticulously performed. Statistical analysis was conducted using Review Manager Software, version 5.4, with significant heterogeneity addressed through appropriate methods. Our meta-analysis included 3 studies with 830 vitiligo patients. Significant improvements were observed in F-VASI, T-VASI, F-BSA, and T-BSA scores, with greater efficacy at 24 weeks compared to 12 weeks [MD –24.17, 95% CI (–31.78 to –16.56), P < 0.00001], [MD –14.12, 95% CI (–20.54 to –7.70); P < 0.0000], [MD –16.25, 95% CI (–22.20 to –10.31),
P
< 0.00001], [MD –9.19, 95% CI (–13.47 to –4.92); P < 0.00001]. Ruxolitinib showed increased risk ratios for F-VASI75, F-VASI90, and F-VASI50, indicating better outcomes with longer treatment durations [MD 2.9, 95% CI 1.88–4.49; P < 0.00001], [MD 4.66, 95% CI 2.09–10.39; P = 0.0002], [MD 2.53, 95% CI 1.84–3.46; P < 0.00001]. No significant differences were found in mild and moderate adverse events, while severe cases favored ruxolitinib. Placebo had a significant advantage in any adverse events, with no significant difference in drug-related adverse events. Serious adverse events did not significantly differ between groups. The findings strongly support the efficacy of ruxolitinib therapy in improving various parameters over time for treating vitiligo. However, thorough consideration of its safety profile, particularly concerning adverse events and potential side effects, is warranted. Further studies with larger sample sizes are needed to confirm these conclusions.]]></abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>39134884</pmid><doi>10.1007/s00403-024-03267-8</doi><orcidid>https://orcid.org/0000-0002-4318-1329</orcidid></addata></record> |
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| ispartof | Archives of dermatological research, 2024-08, Vol.316 (8), p.518, Article 518 |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Adverse events Autoimmune diseases Clinical trials Dermatology Humans Inhibitor drugs Janus kinase Janus kinase 2 Janus Kinase Inhibitors - administration & dosage Janus Kinase Inhibitors - adverse effects Janus Kinase Inhibitors - therapeutic use Medicine Medicine & Public Health Melanocytes Meta-analysis Nitriles Pyrazoles - administration & dosage Pyrazoles - adverse effects Pyrazoles - therapeutic use Pyrimidines - administration & dosage Pyrimidines - therapeutic use Randomized Controlled Trials as Topic Review Side effects Signal transduction Skin Cream - administration & dosage Statistical analysis Topical medication Treatment Outcome Vitiligo Vitiligo - drug therapy |
| title | A meta-analysis of therapeutic trials of topical ruxolitinib cream for the treatment of vitiligo: therapeutic efficacy, safety, and implications for therapeutic practice |
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