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Efficacy and safety of abrocitinib and upadacitinib versus dupilumab in adults with moderate-to-severe atopic dermatitis: A systematic review and meta-analysis
BACKGROUND: The sparsity of head-to-head trials for medications used as in atopic dermatitis (AD) treatment makes therapy options difficult. OBJECTIVE: To better compare the efficacy and safety of abrocitinib and upadacitinib with dupilumab in patients with moderate-to-severe AD. METHODS: We systema...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10272339/ https://www.ncbi.nlm.nih.gov/pubmed/37332971 http://dx.doi.org/10.1016/j.heliyon.2023.e16704 |
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author | Gao, Qin Zhao, Yanxia Zhang, Junling |
author_facet | Gao, Qin Zhao, Yanxia Zhang, Junling |
author_sort | Gao, Qin |
collection | PubMed |
description | BACKGROUND: The sparsity of head-to-head trials for medications used as in atopic dermatitis (AD) treatment makes therapy options difficult. OBJECTIVE: To better compare the efficacy and safety of abrocitinib and upadacitinib with dupilumab in patients with moderate-to-severe AD. METHODS: We systematically searched MEDLINE, EMBASE, and the Cochrane Library database for head-to-head trials. RESULTS: Three studies with 2256 patients were included. The analysis revealed that improvement of EASI-75 was rapidly registered with abrocitinib/upadacitinib as compared to the dupilumab, even as early as week 2 of treatment. The proportions of patients who reached the endpoint of EASI-75 at week 12 and end of therapy were also higher in the abrocitinib/upadacitinib group. Significant improvement in EASI-90 scores was demonstrated with abrocitinib/upadacitinib at week 2 and at all subsequent time points. The administration of abrocitinib/upadacitinib provided a faster onset of IGA response at week 2. The differences in IGA response remained significant at week 12 and end of therapy. Compared with dupilumab, a larger proportion of patients treated with abrocitinib/upadacitinib achieved early itch relief at 2 weeks. Better results were found later during treatment, in between the 12 weeks to the end of study in abrocitinib/upadacitinib group. The only observed significant result of adverse events were severe adverse events between the abrocitinib/upadacitinib group (n = 40) and the dupilumab group (n = 24) (p = 0.043). TEAEs of any causality that led to treatment discontinuation and serious adverse events have not shown special risks in the patients treated with abrocitinib/upadacitinib. CONCLUSIONS: This study demonstrated that anti-JAK therapy, particularly abrocitinib and upadacitinib, exhibited superiority over dupilumab in achieving fast relief of disease signs with an acceptable safety profile in patients with moderate-to-severe atopic dermatitis. |
format | Online Article Text |
id | pubmed-10272339 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-102723392023-06-17 Efficacy and safety of abrocitinib and upadacitinib versus dupilumab in adults with moderate-to-severe atopic dermatitis: A systematic review and meta-analysis Gao, Qin Zhao, Yanxia Zhang, Junling Heliyon Review Article BACKGROUND: The sparsity of head-to-head trials for medications used as in atopic dermatitis (AD) treatment makes therapy options difficult. OBJECTIVE: To better compare the efficacy and safety of abrocitinib and upadacitinib with dupilumab in patients with moderate-to-severe AD. METHODS: We systematically searched MEDLINE, EMBASE, and the Cochrane Library database for head-to-head trials. RESULTS: Three studies with 2256 patients were included. The analysis revealed that improvement of EASI-75 was rapidly registered with abrocitinib/upadacitinib as compared to the dupilumab, even as early as week 2 of treatment. The proportions of patients who reached the endpoint of EASI-75 at week 12 and end of therapy were also higher in the abrocitinib/upadacitinib group. Significant improvement in EASI-90 scores was demonstrated with abrocitinib/upadacitinib at week 2 and at all subsequent time points. The administration of abrocitinib/upadacitinib provided a faster onset of IGA response at week 2. The differences in IGA response remained significant at week 12 and end of therapy. Compared with dupilumab, a larger proportion of patients treated with abrocitinib/upadacitinib achieved early itch relief at 2 weeks. Better results were found later during treatment, in between the 12 weeks to the end of study in abrocitinib/upadacitinib group. The only observed significant result of adverse events were severe adverse events between the abrocitinib/upadacitinib group (n = 40) and the dupilumab group (n = 24) (p = 0.043). TEAEs of any causality that led to treatment discontinuation and serious adverse events have not shown special risks in the patients treated with abrocitinib/upadacitinib. CONCLUSIONS: This study demonstrated that anti-JAK therapy, particularly abrocitinib and upadacitinib, exhibited superiority over dupilumab in achieving fast relief of disease signs with an acceptable safety profile in patients with moderate-to-severe atopic dermatitis. Elsevier 2023-06-02 /pmc/articles/PMC10272339/ /pubmed/37332971 http://dx.doi.org/10.1016/j.heliyon.2023.e16704 Text en © 2023 The Authors. Published by Elsevier Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Review Article Gao, Qin Zhao, Yanxia Zhang, Junling Efficacy and safety of abrocitinib and upadacitinib versus dupilumab in adults with moderate-to-severe atopic dermatitis: A systematic review and meta-analysis |
title | Efficacy and safety of abrocitinib and upadacitinib versus dupilumab in adults with moderate-to-severe atopic dermatitis: A systematic review and meta-analysis |
title_full | Efficacy and safety of abrocitinib and upadacitinib versus dupilumab in adults with moderate-to-severe atopic dermatitis: A systematic review and meta-analysis |
title_fullStr | Efficacy and safety of abrocitinib and upadacitinib versus dupilumab in adults with moderate-to-severe atopic dermatitis: A systematic review and meta-analysis |
title_full_unstemmed | Efficacy and safety of abrocitinib and upadacitinib versus dupilumab in adults with moderate-to-severe atopic dermatitis: A systematic review and meta-analysis |
title_short | Efficacy and safety of abrocitinib and upadacitinib versus dupilumab in adults with moderate-to-severe atopic dermatitis: A systematic review and meta-analysis |
title_sort | efficacy and safety of abrocitinib and upadacitinib versus dupilumab in adults with moderate-to-severe atopic dermatitis: a systematic review and meta-analysis |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10272339/ https://www.ncbi.nlm.nih.gov/pubmed/37332971 http://dx.doi.org/10.1016/j.heliyon.2023.e16704 |
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