Inhibidores Janus Cinasa (inhibidores JAK) como terapia de primera línea en pacientes con enfermedad inflamatoria intestinal vs terapia médica convencional. Revisión sistemática

Abstract

Title: Janus Kinase Inhibitors as First-line Therapy in Patients with Inflammatory Bowel Disease Versus Conventional Medical Therapy: A Systematic Review. Objective: To analyze the efficacy and safety of Janus kinase inhibitors as first-line treatment compared with conventional medical therapy in patients with inflammatory bowel disease. Methodology: A systematic review was conducted in accordance with the PRISMA 2020 statement, using the following eligibility criteria: clinical trials and observational studies published in the last 5 years in English and Spanish were included, involving patients over 18 years of age diagnosed with IBD. Databases such as PubMed and Cochrane were searched between November 2024 and April 2025. The risk of bias was assessed using the Rob2 tool for clinical trials and the JBI tool for observational studies. Results: Eleven articles were included, showing that JAK inhibitors (filgotinib and upadacitinib) demonstrated notable superiority in terms of clinical remission, symptom reduction, and improvement in quality of life compared to conventional therapy, which was associated with a higher incidence of adverse effects. Discussion: The studies indicated that JAK inhibitors offered sustainable efficacy and a favorable safety profile; however, most studies had a high risk of bias and small sample sizes. Conclusion: JAK inhibitors presented an effective and safe alternative to conventional therapy, highlighting their significant impact as a first-line treatment for IBD.