Safety and Efficacy of Nemolizumab for Atopic Dermatitis With Pruritus: A Systematic Review and Meta-Regression Analysis of Randomized Controlled Trials

BACKGROUND: Nemolizumab is deemed as a promising drug for atopic dermatitis (AD) patients with pruritus. OBJECTIVE: This study aimed to evaluate the efficacy of nemolizumab in treating patients with AD and the association between the dosage or regimen of nemolizumab with the improvement in clinical indices. METHODS AND MATERIALS: PubMed, Embase, and the Cochrane Library were searched for randomized controlled trials (RCTs) published from inception to August 2021. RESULTS: A total of 14 cohorts of participants from six randomized controlled studies were included in the meta-analysis. Nemolizumab significantly reduced the pruritus VAS (WMD = −18.86, 95% CI: −27.57 to −10.15, p < 0.001; I (2) = 56.2%, p (heterogeneity) = 0.005) and EASI (WMD = −11.76, 95% CI: −20.55 to −2.96, p = 0.009; I (2) = 0%, p (heterogeneity) = 0.978) scores compared with placebo. No significant difference was observed in the occurrence of any AEs (RR = 1.03, 95% CI: 0.93 to 1.13, p = 0.593; I (2) = 0%, p (heterogeneity) = 0.980) between the two groups. The univariate meta-regression showed that both the dosage and study duration had no association with the change of pruritus VAS score. CONCLUSION: Nemolizumab presented a promising effect based on the difference in the average change in pruritus VAS and EASI scores compared with placebo. The results indicated its efficacy in relieving pruritus and the severity of AD and improving patients’ quality of life.