Abstract

Bullous pemphigoid (BP) is considered a chronic autoimmune blistering disorder that affects the elderly and is often associated with long-term immunosuppressive management. Traditional treatment of BP included the use of corticosteroids and immunosuppressants, which can be associated with significant side effects and have limited efficacy in refractory cases. Janus kinase (JAK) inhibitors, including baricitinib, have emerged as potential therapeutic options because of their efficacy in modulating immune response. The current review aimed to systematically evaluate the clinical outcomes of using baricitinib in the management of BP. The data was extracted from a total of five studies, including case reports and case series, regarding patient demographics, comorbidities, clinical presentation, baseline severity of disease, regimen of baricitinib treatment, and outcomes of the management, including clinical improvement, rate of remission, and incidence of adverse events. This review included a total of 13 patients diagnosed with BP with administration of baricitinib at a dose of 4 mg/day. The clinical improvement was observed within 1-4 weeks of treatment, and complete remission within 14.75 weeks (95% CI: 9.69-19.82). The patients reported a significant reduction in Bullous Pemphigoid Disease Area Index (BPDAI) and Visual Analogue Scale (VAS) scores, with many patients reporting tapering or discontinuation of corticosteroids and other immunosuppressants. The use of baricitinib showed good effectiveness and well-tolerated therapeutic outcomes, especially among those with refractory disorder or intolerance to traditional treatment. It was associated with a rapid onset of action, steroid-sparing ability, and a favorable safety profile, indicating its promising role as an emerging treatment strategy.

Key words: Baricitinib, Janus kinase inhibitors, bullous pemphigoid, autoimmune blistering diseases, efficacy, safety, systematic review, meta-analysis.