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

Kelsey B Nusbaum1, Sarah Fleischer2, Alan B Fleischer3

  • 1University of Cincinnati College of Medicine, Cincinnati, OH, USA.

The Journal of Dermatological Treatment
|October 8, 2021
PubMed
Abstract

Insights

Newer targeted therapies like upadacitinib, abrocitinib, and lebrikizumab show superior efficacy for atopic dermatitis (AD) symptom relief and quality of life improvements compared to dupilumab.

Area of Science:

  • Dermatology
  • Pharmacology
  • Clinical Trials

Background:

  • Atopic dermatitis (AD) management is evolving with new targeted therapies.
  • Clinical decision-making requires comparative efficacy data for these agents.

Purpose of the Study:

  • To assess the efficacy of biologics and oral small molecules in treating atopic dermatitis (AD).
  • To evaluate effects on clinical signs, symptoms, and quality of life.

Main Methods:

  • Systematic literature review of phase II and III randomized clinical trials for AD treatments.
  • Meta-analysis using the inverse variance heterogeneity model ((IVhet)) to assess Eczema Area and Severity Index (EASI), Dermatology Life Quality Index (DLQI), and Peak Pruritus Numerical Rating Scale (PP-NRS).

Main Results:

  • Upadacitinib (30 mg), abrocitinib, and lebrikizumab demonstrated higher Eczema Area and Severity Index (EASI) reduction than dupilumab.
  • Lebrikizumab, upadacitinib, and abrocitinib showed greater itch reduction (PP-NRS) compared to dupilumab.
  • Abrocitinib achieved the most significant improvement in Dermatology Life Quality Index (DLQI).

Conclusions:

  • Upadacitinib, abrocitinib, and lebrikizumab offer superior improvements in AD clinical signs, symptoms, and quality of life over dupilumab.
  • These agents represent significant advancements in targeted atopic dermatitis therapy.
Keywords:
Atopic dermatitisclinical trialsoutcome measurestargeted therapies

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