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dc.contributor.authorChu, Alexandro W L
dc.contributor.authorWong, Melanie M
dc.contributor.authorRayner, Daniel G
dc.contributor.authorGuyatt, Gordon H
dc.contributor.authorMartinez, Juan Pablo Díaz
dc.contributor.authorCeccacci, Renata
dc.contributor.authorZhao, Irene X
dc.contributor.authorMcMullen, Eric
dc.contributor.authorSrivastava, Archita
dc.contributor.authorWang, Jason
dc.contributor.authorWen, Aaron
dc.contributor.authorWang, Fang Chi
dc.contributor.authorBrignardello-Petersen, Romina
dc.contributor.authorIzcovich, Ariel
dc.contributor.authorOykhman, Paul
dc.contributor.authorWheeler, Kathryn E
dc.contributor.authorWang, Julie
dc.contributor.authorSpergel, Jonathan M
dc.contributor.authorSingh, Jasvinder A
dc.contributor.authorSilverberg, Jonathan I
dc.contributor.authorOng, Peck Y
dc.contributor.authorO'Brien, Monica
dc.contributor.authorMartin, Stephen A
dc.contributor.authorLio, Peter A
dc.contributor.authorLind, Mary Laura
dc.contributor.authorLeBovidge, Jennifer
dc.contributor.authorKim, Elaine
dc.contributor.authorHuynh, Joey
dc.contributor.authorGreenhawt, Matthew
dc.contributor.authorGardner, Donna D
dc.contributor.authorFrazier, Winfred T
dc.contributor.authorEllison, Kathy
dc.contributor.authorChen, Lina
dc.contributor.authorCapozza, Korey
dc.contributor.authorDe Benedetto, Anna
dc.contributor.authorBoguniewicz, Mark
dc.contributor.authorSmith Begolka, Wendy
dc.contributor.authorAsiniwasis, Rachel N
dc.contributor.authorSchneider, Lynda C
dc.contributor.authorChu, Derek K
dc.date.accessioned2023-10-27T19:30:20Z
dc.date.available2023-10-27T19:30:20Z
dc.date.issued2023-09-05
dc.identifier.citationChu AWL, Wong MM, Rayner DG, Guyatt GH, Martinez JPD, Ceccacci R, Zhao IX, McMullen E, Srivastava A, Wang J, Wen A, Wang FC, Brignardello-Petersen R, Izcovich A, Oykhman P, Wheeler KE, Wang J, Spergel JM, Singh JA, Silverberg JI, Ong PY, O'Brien M, Martin SA, Lio PA, Lind ML, LeBovidge J, Kim E, Huynh J, Greenhawt M, Gardner DD, Frazier WT, Ellison K, Chen L, Capozza K, De Benedetto A, Boguniewicz M, Smith Begolka W, Asiniwasis RN, Schneider LC, Chu DK. Systemic treatments for atopic dermatitis (eczema): systematic review and network meta-analysis of randomized trials. J Allergy Clin Immunol. 2023 Sep 5:S0091-6749(23)01112-0. doi: 10.1016/j.jaci.2023.08.029. Epub ahead of print. PMID: 37678577.en_US
dc.identifier.eissn1097-6825
dc.identifier.doi10.1016/j.jaci.2023.08.029en_US
dc.identifier.pmid37678577
dc.identifier.urihttp://hdl.handle.net/20.500.14038/52651
dc.description.abstractBackground: Atopic dermatitis (AD) is an inflammatory skin condition with multiple systemic treatments and uncertainty regarding their comparative impact on AD outcomes. Objective: We systematic synthesized the benefits and harms of AD systemic treatments. Methods: For the 2023 AAAAI/ACAAI JTFPP AD guidelines, we searched MEDLINE, EMBASE, CENTRAL, Web of Science, and GREAT, from inception to November 29, 2022, for randomized trials addressing systemic treatments and phototherapy for AD. Paired reviewers independently screened records, extracted data, and assessed risk of bias. Random-effects network meta-analyses addressed AD severity, itch, sleep, AD-quality of life, flares, and harms. The GRADE approach informed certainty of evidence ratings. OSF: https://osf.io/e5sna. Results: 149 included trials (28,686 patients with moderate-to-severe AD) evaluated 75 interventions. With high-certainty, high-dose upadacitinib was among the most effective for five of six patient-important outcomes; high-dose abrocitinib and low-dose upadacitinib were among the most effective for two outcomes. These JAK inhibitors were among the most harmful in increasing adverse events. With high-certainty, dupilumab, lebrikizumab, and tralokinumab were of intermediate effectiveness and among the safest-modestly increasing conjunctivitis. Low-dose baricitinib was among the least effective. The efficacy and safety of azathioprine, oral corticosteroids, cyclosporine, methotrexate, mycophenolate, phototherapy, and many novel agents are less certain. Conclusions: Among individuals with moderate-to-severe AD, high-certainty evidence demonstrates that high-dose upadacitinib is among the most effective in addressing multiple patient-important outcomes but also among the most harmful. High-dose abrocitinib and low-dose upadacitinib are effective, but also among the most harmful. Dupilumab, lebrikizumab, and tralokinumab are of intermediate effectiveness and favorable safety.en_US
dc.language.isoenen_US
dc.relation.ispartofJournal of Allergy and Clinical Immunologyen_US
dc.relation.urlhttps://doi.org/10.1016/j.jaci.2023.08.029en_US
dc.rightsCopyright © 2023. Published by Elsevier Inc.en_US
dc.subjectGRADEen_US
dc.subjectJAK inhibitorsen_US
dc.subjectJanus Kinaseen_US
dc.subjectabrocitiniben_US
dc.subjectadverse eventsen_US
dc.subjectatopic dermatitisen_US
dc.subjectazathioprineen_US
dc.subjectbaricitiniben_US
dc.subjectbiologicsen_US
dc.subjectcomparative effectsen_US
dc.subjectcorticosteroidsen_US
dc.subjectcyclosporineen_US
dc.subjectdisease severityen_US
dc.subjectdupilumaben_US
dc.subjecteczemaen_US
dc.subjectimmunomodulatorsen_US
dc.subjectimmunosuppressantsen_US
dc.subjectitchen_US
dc.subjectlebrikizumaben_US
dc.subjectlight therapyen_US
dc.subjectmethotrexateen_US
dc.subjectmonoclonal antibodiesen_US
dc.subjectmycophenolateen_US
dc.subjectnarrow-band UVBen_US
dc.subjectnemolizumaben_US
dc.subjectnetwork meta-analysisen_US
dc.subjectpatient-important outcomesen_US
dc.subjectphototherapyen_US
dc.subjectquality of lifeen_US
dc.subjectsleepen_US
dc.subjectsystemic treatmentsen_US
dc.subjecttralokinumaben_US
dc.subjectupadacitiniben_US
dc.titleSystemic treatments for atopic dermatitis (eczema): systematic review and network meta-analysis of randomized trialsen_US
dc.typeJournal Articleen_US
dc.source.journaltitleThe Journal of allergy and clinical immunology
dc.source.countryUnited States
dc.identifier.journalThe Journal of allergy and clinical immunology
dc.contributor.departmentFamily Medicine and Community Healthen_US


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