Efficacy and safety of upadacitinib in the treatment of moderate-to-severe atopic dermatitis: A systematic review.
<h4>Objective</h4>To evaluate the efficacy and safety of upadacitinib in the treatment of moderate-to-severe atopic dermatitis (AD), and provide reference for rational clinical medication.<h4>Methods</h4>PubMed, Medline, Embase, Web of Science, Clinical Trials Website, and Co...
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Public Library of Science (PLoS)
2024-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0306463 |
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| author | Dan-Jie Zhao Xia Li Hai-Xia Lin Hong Zheng Di Zhou Peng Tang |
| author_facet | Dan-Jie Zhao Xia Li Hai-Xia Lin Hong Zheng Di Zhou Peng Tang |
| author_sort | Dan-Jie Zhao |
| collection | DOAJ |
| description | <h4>Objective</h4>To evaluate the efficacy and safety of upadacitinib in the treatment of moderate-to-severe atopic dermatitis (AD), and provide reference for rational clinical medication.<h4>Methods</h4>PubMed, Medline, Embase, Web of Science, Clinical Trials Website, and Cochrane Library databases were searched from the time of establishment until January 6, 2024, to compile a list of all randomized controlled trials (RCTs) including upadacitinib in the treatment of moderate-to-severe AD. The quality of the included studies was evaluated using the Cochrane Systematic Review. Review Manager 5.3 software was utilized for statistical analysis of outcome measures.<h4>Results</h4>A total of five studies were included in the meta-analysis. The results revealed that the 15 mg and 30 mg upadacitinib significantly improved Eczema Area and Severity Index (EASI) 75% {[Odds Ratio (OR) = 8.58, 95% confidence interval (CI) (5.84-12.60), P < 0.00001] [OR = 15.62, 95% CI (10.89-22.42), P < 0.00001]}, Numerical Rating Scale (NRS) ≥ 4 {[OR = 7.13, 95% CI (5.63-9.01), P < 0.00001] [OR = 11.30, 95% CI (8.93-14.31), P < 0.00001]}, and Investigator's Global Assessment (IGA) 0/1 {[OR = 8.63, 95% CI (6.60-11.27), P < 0.00001] [OR = 16.04, 95% CI (12.26-20.99), P < 0.00001]} compared to placebo. In terms of safety, although 15 mg and 30 mg upadacitinib significantly increased the overall adverse events rate compared to placebo {[OR = 1.31, 95% CI (1.09-1.58), P = 0.004] [OR = 1.85, 95% CI (1.54-2.21), P < 0.00001]}, there was no significant difference in the serious adverse events rate {[OR = 0.73, 95% CI (0.41-1.29), P = 0.28] [OR = 0.69, 95% CI (0.39-1.23), P = 0.21]} and withdrawal rate due to adverse events {[OR = 0.66, 95% CI (0.39-1.11), P = 0.12] [OR = 0.85, 95% CI (0.52-1.38), P = 0.50]} compared to placebo.<h4>Conclusion</h4>This meta-analysis preliminarily suggests that upadacitinib is effective and safe for usage in the treatment of moderate-to-severe AD. Additionally, upadacitinib can instantly relieve itchiness and effectively reduce symptoms and signs, with its 30-mg dose being more effective than the 15-mg dose. |
| format | Article |
| id | doaj-art-8c9b30e743a4494aa4b6608b1801cee5 |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj-art-8c9b30e743a4494aa4b6608b1801cee52025-01-21T05:31:24ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-01197e030646310.1371/journal.pone.0306463Efficacy and safety of upadacitinib in the treatment of moderate-to-severe atopic dermatitis: A systematic review.Dan-Jie ZhaoXia LiHai-Xia LinHong ZhengDi ZhouPeng Tang<h4>Objective</h4>To evaluate the efficacy and safety of upadacitinib in the treatment of moderate-to-severe atopic dermatitis (AD), and provide reference for rational clinical medication.<h4>Methods</h4>PubMed, Medline, Embase, Web of Science, Clinical Trials Website, and Cochrane Library databases were searched from the time of establishment until January 6, 2024, to compile a list of all randomized controlled trials (RCTs) including upadacitinib in the treatment of moderate-to-severe AD. The quality of the included studies was evaluated using the Cochrane Systematic Review. Review Manager 5.3 software was utilized for statistical analysis of outcome measures.<h4>Results</h4>A total of five studies were included in the meta-analysis. The results revealed that the 15 mg and 30 mg upadacitinib significantly improved Eczema Area and Severity Index (EASI) 75% {[Odds Ratio (OR) = 8.58, 95% confidence interval (CI) (5.84-12.60), P < 0.00001] [OR = 15.62, 95% CI (10.89-22.42), P < 0.00001]}, Numerical Rating Scale (NRS) ≥ 4 {[OR = 7.13, 95% CI (5.63-9.01), P < 0.00001] [OR = 11.30, 95% CI (8.93-14.31), P < 0.00001]}, and Investigator's Global Assessment (IGA) 0/1 {[OR = 8.63, 95% CI (6.60-11.27), P < 0.00001] [OR = 16.04, 95% CI (12.26-20.99), P < 0.00001]} compared to placebo. In terms of safety, although 15 mg and 30 mg upadacitinib significantly increased the overall adverse events rate compared to placebo {[OR = 1.31, 95% CI (1.09-1.58), P = 0.004] [OR = 1.85, 95% CI (1.54-2.21), P < 0.00001]}, there was no significant difference in the serious adverse events rate {[OR = 0.73, 95% CI (0.41-1.29), P = 0.28] [OR = 0.69, 95% CI (0.39-1.23), P = 0.21]} and withdrawal rate due to adverse events {[OR = 0.66, 95% CI (0.39-1.11), P = 0.12] [OR = 0.85, 95% CI (0.52-1.38), P = 0.50]} compared to placebo.<h4>Conclusion</h4>This meta-analysis preliminarily suggests that upadacitinib is effective and safe for usage in the treatment of moderate-to-severe AD. Additionally, upadacitinib can instantly relieve itchiness and effectively reduce symptoms and signs, with its 30-mg dose being more effective than the 15-mg dose.https://doi.org/10.1371/journal.pone.0306463 |
| spellingShingle | Dan-Jie Zhao Xia Li Hai-Xia Lin Hong Zheng Di Zhou Peng Tang Efficacy and safety of upadacitinib in the treatment of moderate-to-severe atopic dermatitis: A systematic review. PLoS ONE |
| title | Efficacy and safety of upadacitinib in the treatment of moderate-to-severe atopic dermatitis: A systematic review. |
| title_full | Efficacy and safety of upadacitinib in the treatment of moderate-to-severe atopic dermatitis: A systematic review. |
| title_fullStr | Efficacy and safety of upadacitinib in the treatment of moderate-to-severe atopic dermatitis: A systematic review. |
| title_full_unstemmed | Efficacy and safety of upadacitinib in the treatment of moderate-to-severe atopic dermatitis: A systematic review. |
| title_short | Efficacy and safety of upadacitinib in the treatment of moderate-to-severe atopic dermatitis: A systematic review. |
| title_sort | efficacy and safety of upadacitinib in the treatment of moderate to severe atopic dermatitis a systematic review |
| url | https://doi.org/10.1371/journal.pone.0306463 |
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