类风湿性关节炎（RA）是一种慢性全身性自身免疫性疾病，其特征是持续炎症导致残疾逐渐恶化。 Janus 激酶 (JAK) 抑制剂和肿瘤坏死因子 (TNF) 抑制剂在 RA 治疗中至关重要，但其疗效比较仍待探索。本研究旨在使用随机对照试验的数据来比较 JAK 抑制剂和 TNF 抑制剂治疗 RA 的疗效和安全性试验（RCT）。荟萃分析和结果分析基于健康评估问卷残疾指数（HAQ-DI）、临床疾病活动指数（CDAI）、视觉模拟量表（VAS）和患者总体评估量表（ PtGA) 和其他指标作为静脉血栓栓塞 (VTE) 和恶性肿瘤的发生率。与相比，JAK 抑制剂导致 HAQ-DI 评分有统计学显着改善 [MD = 0.08, 95% CI (0.03, 0.12), p = 0.0008] TNF抑制剂。然而，两种药物类别之间的 CDAI 评分没有观察到显着差异 [MD = - 2.03, 95% CI (- 9.27, 5.22), p = 0.58]。 JAK抑制剂与VAS评分的增加相关[MD = 3.62，95% CI (0.86, 6.38)，p = 0.01]，但PtGA评分没有显着差异[MD = 1.91，95% CI (- 3.25, 7.08), p = 0.47]。与 TNF 抑制剂相比，JAK 抑制剂在改善 RA 患者的功能状态和降低疾病活动方面具有卓越的功效。尽管 JAK 抑制剂的血栓栓塞风险较高，但这两种药物在 VTE 和恶性肿瘤方面表现出相当的安全性。© 2024。作者，获得 Springer Nature Switzerland AG 的独家许可。

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disorder characterized by persistent inflammation leading to progressively worse disability. Janus kinase (JAK) inhibitors and tumor necrosis factor (TNF) inhibitors are pivotal in RA treatment, yet their comparative efficacy remains underexplored.This study aimed to compare the efficacy and safety of JAK inhibitors and TNF inhibitors in treating RA using data from randomized controlled trials (RCTs).A meta-analysis and outcomes analysis were based on results of the Health Assessment Questionnaire Disability Index (HAQ-DI), Clinical Disease Activity Index (CDAI), Visual Analogue Scale (VAS), and Patient Global Assessment Scale (PtGA) and other indices as incidences of venous thromboembolism (VTE) and malignancy.The JAK inhibitors caused a statistically significant improvement in the HAQ-DI score [MD = 0.08, 95% CI (0.03, 0.12), p = 0.0008] compared with the TNF inhibitors. However, no significant difference was observed between the two drug classes in the CDAI score [MD = - 2.03, 95% CI (- 9.27, 5.22), p = 0.58]. JAK inhibitors were associated with an increase in the VAS score [MD = 3.62, 95% CI (0.86, 6.38), p = 0.01], but there was no significant difference in the PtGA score [MD = 1.91, 95% CI (- 3.25, 7.08), p = 0.47].JAK inhibitors demonstrated superior efficacy in improving the functional status and reducing the disease activity in RA patients compared with TNF inhibitors. Both drug classes exhibited comparable safety profiles for VTE and malignancies, though JAK inhibitors had a higher risk for thromboembolism.© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.