# Oral JAK Inhibitors as a Promising Therapeutic Strategy for Refractory Rosacea: A Systematic Review and Meta‐Analysis

## TL;DR

Oral JAK inhibitors may be a promising treatment for difficult-to-treat rosacea, but more research is needed to confirm their effectiveness and safety.

## Contribution

This study provides the first systematic review and meta-analysis of oral JAK inhibitors for refractory rosacea.

## Key findings

- Oral JAK inhibitors showed an 89.9% pooled clinical response rate in treating refractory rosacea.
- Patients experienced significant improvements in erythema and quality of life measures.
- Adverse events occurred in 10.5% of patients, indicating a generally favorable safety profile.

## Abstract

Rosacea is a chronic inflammatory dermatosis. While standard therapies exist, managing refractory subtypes remains a therapeutic challenge. Oral Janus kinase (JAK) inhibitors have emerged as potential alternatives, but systematic evidence is lacking.

To evaluate the efficacy and safety of oral JAK inhibitors for rosacea through a systematic review and meta‐analysis.

A comprehensive search was conducted in five databases from inception to December 1, 2025. The primary outcome was the pooled clinical response rate. Secondary outcomes included the Investigator's Global Assessment (IGA), Clinician's Erythema Assessment (CEA), and Dermatology Life Quality Index (DLQI).

Eleven studies involving 57 patients were included. The overall pooled response rate was 89.9% (95% CI: 74.4%–99.4%), with low heterogeneity (I
2 = 16.3%). Regarding secondary outcomes, 67.8% of patients achieved an IGA score of ≤ 1, and 74.6% achieved a CEA reduction of ≥ 2 points. DLQI score also decreased from 17.30 ± 3.80 to 10.00 ± 3.43. Adverse events were reported in 10.5% of patients.

Oral JAK inhibitors show promising potential as a therapeutic option for refractory rosacea. However, given the small sample size and single‐arm design, these findings are exploratory. Large‐scale randomized controlled trials are urgently needed to validate these findings and guide stratified treatment.