Evidence map›Paper›PMID 36013338›Full record

ReviewLife (Basel, Switzerland)2022

Long-Term Effectiveness and Safety of Biologic and Small Molecule Drugs for Moderate to Severe Atopic Dermatitis: A Systematic Review.

Angela Ayen-Rodríguez, José-Juan Pereyra-Rodríguez, Francisco J Navarro-Triviño, Sara Alcantara-Luna, Javier Domínguez-Cruz, Manuel Galán-Gutiérrez, Samuel Vilar-Palomo, Jose Carlos Armario-Hita, Ricardo Ruiz-Villaverde

Open access · goldAbstract readReview
In one paragraph

Review in Life (Basel, Switzerland), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 1 country.

Angela Ayen-RodríguezDermatology Department, Hospital Universitario San Cecilio, 18016 Granada, Spain.ORCID 0000-0002-3445-8613
José-Juan Pereyra-RodríguezDermatology Department, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain.ORCID 0000-0001-6843-5877
Francisco J Navarro-TriviñoDermatology Department, Hospital Universitario San Cecilio, 18016 Granada, Spain.ORCID 0000-0002-5454-3671
Sara Alcantara-LunaDermatology Department, Hospital Juan Ramón Jiménez, 21005 Huelva, Spain.
Javier Domínguez-CruzDermatology Department, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain.
Manuel Galán-GutiérrezDermatology Department, Hospital Universitario Reina Sofia, 14004 Cordoba, Spain.
Samuel Vilar-PalomoNursing Department, Faculty of Nursing, Physiotherapy and Podiatry, Sevilla University, 41004 Sevilla, Spain.ORCID 0000-0002-2241-033X
Jose Carlos Armario-HitaDermatology Department, Hospital Universitario Puerto Real, 11510 Cádiz, Spain.
Ricardo Ruiz-VillaverdeDermatology Department, Hospital Universitario San Cecilio, 18016 Granada, Spain.ORCID 0000-0002-0381-6174
Instituto de Investigación Biosanitaria de Granada · ESHospital Universitario Virgen del Rocío · ESHospital Juan Ramón Jiménez · ESHospital Universitario Puerto Real · ESHospital Universitario Reina Sofía · ESUniversidad de Sevilla · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAtopic dermatitis (AD) is a genetically based chronic inflammatory dermatosis associated with multiple triggers and complex pathophysiological mechanisms. Nowadays, an authentic therapeutic revolution is taking place with the incorporation of biological drugs for the treatment of moderate and severe atopic dermatitis. A new systematic revision (RS) is necessary to support decision-making for specialists treating AD.

methodsA literature search of MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials was performed between 1 January 2000 and 30 April 2022. Phase III randomized clinical trials (RCTs) of EMA-approved molecules were included. The main variables analyzed were a 75% improvement in the Eczema Area and Severity Index (EASI 75) and the number of patients who reached 0 in the Investigator Global Assessment (IGA) (fully cleared patients) or IGA 1 (almost cleared patients) at the end of the study period (week 48-60). The risk of bias was analyzed with the Cochrane Risk of Bias Assessment (ROB-2) tool, focused on the primary objectives. Before carrying out the study, the protocol was registered in PROSPERO with the number CRD42022331109.

resultsA total of 3299 studies were systematically identified via databases and registers (442 from PubMed/MEDLINE, 2857 from Embase and 719 from CENTRAL). Finally, five publications containing seven RCTs were included in the final sample of detailed data extraction and data analyses. Regarding efficacy, the best results are obtained with Upadacitinib 30 mg (84.7% (77.3-92.1)) at 52 weeks, slightly improving its results when TCS is added (84.9% (80.3-89.5)). These results are replicated in the measurement of vIGA 0/1 for Updacitinib 30 mg + TCS, where 65.5% (55.7-75.2) of patients maintain it at 52 weeks. Of the four drugs, no long-term safety results have been reported for baricitinib. In relation to the safety findings, there were no significant differences in the dropout rates for this reason in the remaining three drugs. DISCUSSION: Today, different therapeutic options for AD patients can be prescribed. Individualizing the treatment allows for better therapeutic consistency, in addition to being cost-efficient to avoid primary therapeutic failures. The results of the present SR may provide us with a useful basis for the preparation of management guidelines for the use of new generation therapies in moderate to severe atopic dermatitis.

Indexed as

atopic dermatitisbiologicEASIIGApruritus NRSsystematic literature reviewtreatment

Identifiers

PMID36013338
PMCPMC9410312
OpenAlexW4289174721

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.