Deucravacitinib for Moderate-to-Severe Psoriasis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

There is contrasting evidence regarding the efficacy and safety of JAK (Janus kinase) inhibitors in the treatment of psoriasis. This systematic review and meta-analysis assessed deucravacitinib, an oral, selective, allosteric tyrosine kinase 2 inhibitor, as the therapy of choice for moderate-to-severe psoriasis. PubMed, Embase, and Cochrane databases were searched for randomized controlled trials, including patients with moderate-to-severe psoriasis. Outcomes of interest were serious adverse events (SAEs), the severity of illness, as measured by the validated questionnaires: Psoriasis Area and Severity Index (PASI) and scalp-specific Physician's Global Assessment (ss-PGA); and quality of life, measured by the Dermatology Life Quality Index (DLQI). Four studies with 1663 patients were included in the meta-analysis, of whom 1123 (67.5%) were treated with deucravacitinib during a 12-to-16-week follow-up. The mean age was 45.4 ± 13.3 years, and 70.2% were male. Two-thirds had a history of scalp psoriasis. Achievement of PASI 75 was significantly higher in the deucravacitinib group, as compared with placebo (RR 5.7; 95% CI 4.32-7.53; P<0.001). Similarly, ss-PGA 0/1 (RR 3.86; 95%CI 3.02-4.94; P<0.001) and DLQI 0/1 (RR 3.89; 2.89-5.22; P<0.001) were also significantly more frequent in the deucravacitinib group. The incidence of SAEs was similar between groups. These findings suggest that patients with moderate-to-severe psoriasis treated with deucravacitinib for 12 to 16 weeks had significantly decreased severity of illness and improved quality of life, without a concerning increase in the incidence of SAEs. J Drugs Dermatol. 2024;23(2):67-73.  doi:10.36849/JDD.7539.

Sublobar resection versus lobectomy for stage IA non-small-cell lung cancer: A systematic review and meta-analysis of randomized controlled trials.

Surgical resection is the first-line treatment for early-stage lung cancer, with lobectomy being the standard choice since the 1960s. Nevertheless, recent studies have shown controversies about whether sublobar resection or lobectomy is the optimal surgical approach today. In this sense, this meta-analysis aims to compare these techniques. PubMed, EMBASE, and Cochrane databases were searched for randomized controlled trials (RCTs) comparing sublobar resection with lobectomy for stage IA non-small-cell lung cancer (NSCLC) and reporting any of the following outcomes: (1) Overall survival (OS); (2) disease-free survival (DFS); and (3) total disease recurrences. Sublobar resection encompassed wedge resection and segmentectomy techniques. A total of 1975 patients from four studies were included, of whom 978 (49.5%) underwent sublobar resection and 973 (49.3%) were male. All tumors were smaller than 2 cm. Follow-up ranged from 5 to 7.3 years. Mean age was 62.8 ± 37.0 years, and 1353 (68.5%) patients had a known smoking history. OS (HR 0.79; 95% CI 0.60-1.05; p = 0.11) and DFS (HR 1.02; 95% CI 0.86-1.22; p = 0.80) did not significantly differ between the sublobar resection and lobectomy groups. Similarly, no significant statistical difference was observed in total disease recurrences (RR 1.17; 95% CI 0.93-1.46; p = 0.17). Subgroup and isolated sublobar resection techniques analyses were not possible due to the lack of data. Sublobar resection and lobectomy have similar OS, DFS, and disease recurrence rates for stage IA NSCLC. These findings underline the need for new RCTs investigating these outcomes in specific patient subgroups and isolated sublobar resection techniques.