Efficacy and safety of systemic targeted therapies for atopic dermatitis in children: A systematic review and meta-analysis
Background: In recent years, several targeted therapeutic options have become available for the management of atopic dermatitis in children. In this systematic review and meta-analysis, we assessed the efficacy and safety of systemic targeted therapies for atopic dermatitis in children. Methods: A s...
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Elsevier
2025-07-01
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| Series: | Allergology International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1323893025000012 |
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| author | Norio Kawamoto Hiroki Murai Kazutaka Nogami Takeshi Yamamoto Tomonobu Kikkawa Motoko Yasutomi-Sakai Kiwako Yamamoto-Hanada Masaki Futamura Yukihiro Ohya |
| author_facet | Norio Kawamoto Hiroki Murai Kazutaka Nogami Takeshi Yamamoto Tomonobu Kikkawa Motoko Yasutomi-Sakai Kiwako Yamamoto-Hanada Masaki Futamura Yukihiro Ohya |
| author_sort | Norio Kawamoto |
| collection | DOAJ |
| description | Background: In recent years, several targeted therapeutic options have become available for the management of atopic dermatitis in children. In this systematic review and meta-analysis, we assessed the efficacy and safety of systemic targeted therapies for atopic dermatitis in children. Methods: A systematic review of literature available in CENTRAL, MEDLINE, Embase, and ICHUSHI databases until January 7, 2023, was performed. Randomized controlled trials of systemic targeted therapies (biologics and small molecules) on children aged 18 years or younger with atopic dermatitis were included. The primary outcomes were the eczema area and severity index (EASI) and adverse events. Other efficacy and safety outcomes were also used for meta-analysis and risk of bias analysis. Results: We included 10 studies reported in 11 articles involving three agents (dupilumab, abrocitinib, and upadacitinib) and 1760 children. Systemic targeted therapies significantly improved eczema severity with an EASI-75 response (risk ratio, 2.99; 95 % confidence interval [CI], 2.66–3.37). However, systemic targeted therapies were associated with treatment-emergent adverse events (risk difference, 0.05; 95 % CI, 0.01–0.09), particularly among small molecules in subgroup analysis, while no such trend was observed with biologics. Systemic targeted therapy also significantly improved other efficacy outcomes, and no significant association was found in the other safety outcomes. There was no risk of bias in any of the outcomes. Conclusions: Our findings indicate that systemic targeted therapies are effective and relatively safe for treating atopic dermatitis in children, although small molecules may pose a slightly higher risk of adverse events. |
| format | Article |
| id | doaj-art-ff863926aaf241a2b9bdd541c94fe68c |
| institution | OA Journals |
| issn | 1323-8930 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Allergology International |
| spelling | doaj-art-ff863926aaf241a2b9bdd541c94fe68c2025-08-20T02:35:19ZengElsevierAllergology International1323-89302025-07-0174342443410.1016/j.alit.2024.11.007Efficacy and safety of systemic targeted therapies for atopic dermatitis in children: A systematic review and meta-analysisNorio Kawamoto0Hiroki Murai1Kazutaka Nogami2Takeshi Yamamoto3Tomonobu Kikkawa4Motoko Yasutomi-Sakai5Kiwako Yamamoto-Hanada6Masaki Futamura7Yukihiro Ohya8Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, JapanDepartment of Pediatrics, Faculty of Medical Sciences, University of Fukui, Fukui, JapanDepartment of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, JapanDepartment of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Pediatrics, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, JapanDepartment of Pediatrics, Faculty of Medical Sciences, University of Fukui, Fukui, JapanAllergy Center, National Center for Child Health and Development, Tokyo, Japan; Corresponding author. Allergy Center, National Center for Child Health and Development, 2-10-1 Okura,Setagaya-ku, Tokyo 157-8535, Japan.Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; Corresponding author. Department of Pediatrics, National Hospital Organization Nagoya Medical Center, 4-1-1 San-no-maru, Naka-ku, Nagoya 460-0001, Japan.Allergy Center, National Center for Child Health and Development, Tokyo, Japan; Department of Occupational and Environmental Health, Graduate School of Medical Sciences, Nagoya City University, Japan; Division of General Allergy, Bantane Hospital, Fujita Health University, JapanBackground: In recent years, several targeted therapeutic options have become available for the management of atopic dermatitis in children. In this systematic review and meta-analysis, we assessed the efficacy and safety of systemic targeted therapies for atopic dermatitis in children. Methods: A systematic review of literature available in CENTRAL, MEDLINE, Embase, and ICHUSHI databases until January 7, 2023, was performed. Randomized controlled trials of systemic targeted therapies (biologics and small molecules) on children aged 18 years or younger with atopic dermatitis were included. The primary outcomes were the eczema area and severity index (EASI) and adverse events. Other efficacy and safety outcomes were also used for meta-analysis and risk of bias analysis. Results: We included 10 studies reported in 11 articles involving three agents (dupilumab, abrocitinib, and upadacitinib) and 1760 children. Systemic targeted therapies significantly improved eczema severity with an EASI-75 response (risk ratio, 2.99; 95 % confidence interval [CI], 2.66–3.37). However, systemic targeted therapies were associated with treatment-emergent adverse events (risk difference, 0.05; 95 % CI, 0.01–0.09), particularly among small molecules in subgroup analysis, while no such trend was observed with biologics. Systemic targeted therapy also significantly improved other efficacy outcomes, and no significant association was found in the other safety outcomes. There was no risk of bias in any of the outcomes. Conclusions: Our findings indicate that systemic targeted therapies are effective and relatively safe for treating atopic dermatitis in children, although small molecules may pose a slightly higher risk of adverse events.http://www.sciencedirect.com/science/article/pii/S1323893025000012Atopic dermatitisChildrenMeta-analysisSystematic reviewSystemic targeted therapy |
| spellingShingle | Norio Kawamoto Hiroki Murai Kazutaka Nogami Takeshi Yamamoto Tomonobu Kikkawa Motoko Yasutomi-Sakai Kiwako Yamamoto-Hanada Masaki Futamura Yukihiro Ohya Efficacy and safety of systemic targeted therapies for atopic dermatitis in children: A systematic review and meta-analysis Allergology International Atopic dermatitis Children Meta-analysis Systematic review Systemic targeted therapy |
| title | Efficacy and safety of systemic targeted therapies for atopic dermatitis in children: A systematic review and meta-analysis |
| title_full | Efficacy and safety of systemic targeted therapies for atopic dermatitis in children: A systematic review and meta-analysis |
| title_fullStr | Efficacy and safety of systemic targeted therapies for atopic dermatitis in children: A systematic review and meta-analysis |
| title_full_unstemmed | Efficacy and safety of systemic targeted therapies for atopic dermatitis in children: A systematic review and meta-analysis |
| title_short | Efficacy and safety of systemic targeted therapies for atopic dermatitis in children: A systematic review and meta-analysis |
| title_sort | efficacy and safety of systemic targeted therapies for atopic dermatitis in children a systematic review and meta analysis |
| topic | Atopic dermatitis Children Meta-analysis Systematic review Systemic targeted therapy |
| url | http://www.sciencedirect.com/science/article/pii/S1323893025000012 |
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