Upadacitinib most effective oral JAK inhibitor for treating atopic dermatitis, study claims
USA: Janus kinase (JAK) inhibitors are an effective treatment for atopic dermatitis (AD) patients, according to results from a new systematic review. Upadacitinib, at 30 mg was shown to be the most efficacious oral JAK inhibitor for AD. The study appears in the journal Skin Health and Disease.
The researchers however add that there is a need for more clinical trial studies with comparisons among JAK inhibitors to confirm these results as well as explore the long-term safety and efficacy of these molecules.
JAK inhibitors are being evaluated as promising upcoming treatments for atopic dermatitis. Kevin P. Lee, the University of Texas at Houston McGovern Medical School, Houston, Texas, USA, and colleagues aimed to systematically assess the efficacy of oral JAK inhibitors in patients with AD and provide comparisons among JAK inhibitors.
For this purpose, the researchers conducted a systematic literature review of JAK inhibitors in AD treatment. Only RCTs of JAK inhibitors for treating AD with more than one study were included. The metan procedure in STATA version 12.1 was used to extract data and perform the meta-analysis. Cochrane Risk of Bias Tool was used to assess the risk of bias.
The four outcomes analyzed included percent change in EASI score, Eczema Area Severity Index (EASI)-75 response (≥75% improvement of EASI score from baseline), percent of subjects achieving Investigator Global Assessment (IGA) of clear or almost clear (IGA 0/1), and ≥ 4-point improvement in pruritus numerical rating scale (NRS).
The findings of the study were as follows:
- Fourteen randomized controlled trials (7051 subjects) assessing three different oral JAK inhibitors (abrocitinib, baricitinib, and upadacitinib) in patients with moderate-to-severe AD were included in the meta-analysis.
- Abrocitinib (100 and 200 mg), baricitinib (1, 2, and 4 mg), and upadacitinib (15 and 30 mg) were all found to be more efficacious compared to placebo in all four outcomes analyzed.
- Upadacitinib 30 mg was more effective than all other dosages of JAK inhibitors in achieving EASI-75, decrease in percent change of EASI, IGA 0/1 response rate, and ≥ 4-point improvement in pruritus NRS.
"JAK inhibitors are an effective treatment for AD," the authors wrote. "We found that upadacitinib, particularly at 30 mg, was significantly more efficacious than both abrocitinib and baricitinib in every outcome analyzed."
Reference:
The study titled, "Oral Janus kinase inhibitors in the treatment of atopic dermatitis: A systematic review and meta-analysis," was published in the journal Skin Health and Disease.
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