Efficacy of biologics and oral small molecules for atopic dermatitis: a systematic review and meta-analysis.

Abstract

BACKGROUND:

As new targeted therapies continue to emerge for atopic dermatitis (AD), comparisons between agents are necessary to inform clinical decision-making.

OBJECTIVES:

Assess the efficacy of biologics and oral small molecules on the clinical signs, symptoms, and quality of life in AD.

METHODS:

A systematic literature review identified phase II and III randomized clinical trials of biologics and oral small molecules in AD. Clinical benefit was assessed for three outcome measures: Eczema Area and Severity Index (EASI), Dermatology Life Quality Index (DLQI), and Peak Pruritus Numerical Rating Scale (PP-NRS) by performing a meta-analysis using the inverse variance heterogeneity model ((IVhet)).

RESULTS:

The highest achievement of 75% reduction in EASI was seen with the higher dose of upadacitinib (30 mg) followed by abrocitinib and lebrikizumab, which outperformed dupilumab. Similarly, the highest proportion achieving at least a 4-point reduction of PP-NRS was seen with lebrikizumab followed by upadacitinib and abrocitinib which had greater reduction of itch than dupilumab. Abrocitinib had the greatest improvement in DLQI.

CONCLUSIONS:

Upadacitinib, abrocitinib, and lebrikizumab had greater improvement of clinical signs, symptoms, and quality of life in AD compared to dupilumab and other targeted therapies.

• Authors: Kelsey B Nusbaum, Sarah Fleischer, Alan B Fleischer Jr
• Journal: The Journal of dermatological treatment (J Dermatolog Treat) Vol. 33 Issue 5 Pg. 2534-2544 (Aug 2022) ISSN: 1471-1753 [Electronic] England
• PMID: 34620047 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)

Chemical References

• Biological Products

Topics

• Biological Products (therapeutic use)
• Dermatitis, Atopic (diagnosis, drug therapy)
• Double-Blind Method
• Humans
• Pruritus (drug therapy)
• Quality of Life
• Severity of Illness Index
• Treatment Outcome