dc.creator | Pereyra-Rodríguez, José-Juan | es |
dc.creator | Alcántara Luna, Sara | es |
dc.creator | Domínguez Cruz, Javier | es |
dc.creator | Galán Gutiérrez, Manuel | es |
dc.creator | Ruíz Villaverde, Ricardo | es |
dc.creator | Vilar Palomo, Samuel | es |
dc.creator | Armario Hita, José Carlos | es |
dc.date.accessioned | 2022-09-06T16:17:47Z | |
dc.date.available | 2022-09-06T16:17:47Z | |
dc.date.issued | 2021 | |
dc.identifier.citation | Pereyra Rodríguez, J.J., Alcántara Luna, S., Domínguez Cruz, J., Galán Gutiérrez, M., Ruíz Villaverde, R., Vilar Palomo, S. y Armario Hita, J.C. (2021). Short-term effectiveness and safety of biologics and small molecule drugs for moderate to severe atopic dermatitis : a systematic review and network meta-analysis. Life, 11 (9), 1-18. | |
dc.identifier.issn | 2075-1729 | es |
dc.identifier.uri | https://hdl.handle.net/11441/136803 | |
dc.description.abstract | Abstract: Background: Some Network Meta-analysis (NMA) has been published regarding atopic
dermatitis (AD). These studies have considered drugs under investigation both in monotheraphy or
in combination with topical corticosteroids, as well as systemic immunosuppressant therapies. The
objective of this study is to evaluate the efficacy and safety of biological agents and small molecules
in AD. Methods: A systematic review and NMA of biologics agents and small molecules in AD was
performed. A literature search was performed using MEDLINE, EMBASE, and the Cochrane Central
Register of Controlled Trials for clinical trials and systematic reviews between January 2000 and
19 December 2020. Only randomized clinical trials (RCTs) were included. It was limited to English
language and adult human subjects. Two networks were evaluated: monotherapy and combination
with TCS. The two primary outcomes were Eczema Area and Severity Index (EASI) 75 and EASI 90
change from baseline to week 12–16, depending on source study cut-off. The Cochrane’s Risk of Bias
tool 2011 update was used to analyze the risk of bias, focused on the primary objectives. Results:
30 RCTs (included in 26 publications) were included in the systematic review. Finally, 23 RCTs
were included in the quantitative analysis (14 RCTs including 3582 patients in monotherapy; and
9 RCTs including 3686 patients with TCS). In monotherapy, a higher percentage of patients achieving
EASI-75 was obtained with Upadacitinib 30 mg [OR: 18.90 (13.94; 25.62)] followed by Abrocitinib
200 mg [OR = 11.26 (7.02; 18.05)] and Upadacitinib 15 mg [OR: 10.89 (8.13; 14.59)]. These results were
also observed in studies where the use of topical corticosteroid (TCS) was allowed (OR Upadacitinib
30 mg = 9.43; OR Abrocitinib 200 mg = 6.12; OR Upadacitinib 15 mg = 5.20). Regarding IGA, the
percentage of patients achieving IGA0/1 was higher with both doses of Upadacitinib 30 mg [OR:
19.13 (13.14; 27.85)] and 15 mg [OR = 10.95 (7.52; 15.94). In studies where the use of TCS were
allowed, however, the dose of Abrocitinib 200 mg [OR = 6.10 (3.94; 9.44)] showed higher efficacy
than Upadacitinib 15 mg [OR = 5.47 (3.57; 8.41)]. Regarding safety, the drugs with the highest
probability of presenting adverse effects were the Janus kinases (JAK) inhibitors, Upadacitinib and
Abrocitinib in monotherapy and Baricitinib in combination with TCS. Discussion: Some risks of bias
have been found, which must be taken into account when interpreting the results. The funnel plot
shows a possible publication bias that may underestimate the efficacy of drugs. Upadacitinib and
Abrocitinib are the drugs with the highest efficacy, both in monotherapy and in association with
TCS. However, they were also those associated with the highest risk of adverse effects, showing
monoclonal antibodies better safety profile. Limitations: We have included molecules still in the
development phase as well studies completed and presented at conferences and with data available
in Trialsgov® but not published yet. Several molecules’ development had included a small number
of patients from 12 to 17 years of age, without being able to differentiate the results from the adult
population. Other: Founding: None. PROSPERO database registration number CRD42021225793. | es |
dc.format | application/pdf | es |
dc.format.extent | 18 p. | es |
dc.language.iso | eng | es |
dc.publisher | MDPI AG | es |
dc.relation.ispartof | Life, 11 (9), 1-18. | |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 Internacional | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
dc.subject | atopic dermatitis | es |
dc.subject | meta-analysis | es |
dc.subject | biological agents | es |
dc.title | Short-term effectiveness and safety of biologics and small molecule drugs for moderate to severe atopic dermatitis : a systematic review and network meta-analysis | es |
dc.type | info:eu-repo/semantics/article | es |
dcterms.identifier | https://ror.org/03yxnpp24 | |
dc.type.version | info:eu-repo/semantics/publishedVersion | es |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | es |
dc.contributor.affiliation | Universidad de Sevilla. Departamento de Medicina | es |
dc.contributor.affiliation | Universidad de Sevilla. Departamento de Enfermería | es |
dc.relation.publisherversion | https://www.mdpi.com/2075-1729/11/9/927 | es |
dc.identifier.doi | 10.3390/life11090927 | es |
dc.journaltitle | Life | es |
dc.publication.volumen | 11 | es |
dc.publication.issue | 9 | es |
dc.publication.initialPage | 1 | es |
dc.publication.endPage | 18 | es |