<b>Evaluation of the Effects of Baricitinib and Ruxolitinib in Acute Respiratory Distress Syndrome (ARDS) Patients: A Meta-Analysis Study</b>

Background: Acute respiratory distress syndrome (ARDS) is a severe lung disease with a high rate of morbidity and mortality. Baricitinib and Ruxolitinib, known as Janus kinase (JAK) inhibitors, have shown promise in mitigating the inflammatory response associated with ARDS. This study aims to systematically compare the effects of baricitinib and ruxolitinib in ARDS patients by pooling data from relevant clinical trials and observational studies. Methods: After searching international databases, including Web of Science (WoS), Medline, Embase, and Google Scholar with MeSH phrases and keywords, 9 studies were obtained for further analysis. The statistical analysis of the data was conducted by using a random-effects model. The I2 index and the chi-squared test were employed to compute heterogeneity. Egger’s tests and Begg’s funnel plots were employed to assess publication bias. Results: A total of 484 ARDS patients were examined from nine articles. The pooled ages of ARDS patients who received baricitinib and ruxolitinib were 63.25 years (61.42-65.08) and 63.12 years (59.53-66.72), respectively. In comparison to standard treatment or a placebo, the pooled data showed a significant decrease in mortality rates among ARDS patients treated with baricitinib and ruxolitinib.; the rate of mortality at 28-days in ARDS patients who received baricitinib and ruxolitinib was 11% (95% CI: 3%-19%), and 37% (95% CI: 31%-43%), respectively. Also, findings revealed that the average duration of invasive ventilation in ARDS patients who received ruxolitinib was 14 days (95% CI: 3%-25%). Our analysis revealed no significant publication bias (p-value&gt;0.05). Conclusion: In conclusion, baricitinib and ruxolitinib have shown promising efficacy, immunogenicity, and safety profiles in ARDS patients.