Objective Systematic evaluation of the clinical efficacy and safety of upadacitinib in the treatment of moderate-to-severe atopic dermatitis in adolescents and adults. Method The literatures about upadacitinib treatment for atopic dermatitis were searched from PubMed, Cochrane Library, Web of Science, Embase, CNKI, VPCS and WanFang databases during the inception to June 2024. After quality evaluation of the included studies, Revman 5.4.1 system evaluation software was used to conduct a meta-analysis on the efficacy and safety of the two groups. Results A total of four articles comprising five randomized controlled trials (RCTs) involving 3 023 patients were included. Meta analysis showed that compared with the control group, the experimental group showed a higher level in 75% improvement in Eczema Area and Severity Index (EASI-75), response rate (RR=3.97, 95%CI: 3.21-4.92) and Investigator's Global Assessment (IGA) response rate (RR=6.33, 95%CI: 5.40-7.42), and the improvement of Numerical Rating Scale (NRS) scores (RR=4.57, 95%CI: 4.02-5.20) was more significant. In addition, the incidence of Treatment-Emergent Adverse Event (TEAE) was greater in the experimental group compared to the control group (RR=1.16, 95%CI: 1.10-1.22), and the difference was statistically significant. While there was no significant difference in Serious Adverse Event (SAE) between the two groups (RR=0.74, 95%CI: 0.50-1.11). Among common adverse reactions, the test group is more likely to experience acne (RR=5.26, 95%CI: 3.49-7.93), creatine phosphokinase elevation (RR=2.19, 95%CI: 1.38-3.48), and herpes zoster (RR=2.76, 95%CI: 1.16-6.56). There was no significant difference in the incidence of nasopharyngitis (RR=1.28, 95%CI: 1.00-1.64) and upper respiratory tract infection (RR=1.32, 95%CI: 0.98-1.76) between the two groups. Conclusion Upadacitinib demonstrates efficacy and safety in individuals diagnosed with moderate-to-severe atopic dermatitis. It can improve the skin condition, alleviate itching, and the adverse reactions can be tolerated.
Key words
upadacitinib /
JAK inhibitors /
atopic dermatitis /
efficacy /
safety /
meta-analysis
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