Evidence map›Paper›PMID 41652607›Full record

SynthesisBMC medicine2026

Risk assessment of asthma and allergic rhinitis in atopic dermatitis patients treated with biologics and JAK inhibitors: a systematic review and network meta-analysis of randomized controlled trials.

Liling Zeng, Tong Zhou, Lishan Zhang, Mo Xian, Zheng Zhu, Jing Liu, Shiyan Fu, Hualian Luo, Jing Li

Abstract readSystematic ReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Liling ZengDepartment of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, China.
Tong ZhouDepartment of Respiratory and Critical Care Medicine, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, China.
Lishan ZhangDepartment of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, China.
Mo XianDepartment of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, China.
Zheng ZhuDepartment of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, China.
Jing LiuDepartment of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, China.
Shiyan FuDepartment of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, China.
Hualian LuoDepartment of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, China.
Jing LiDepartment of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, China. lijing@gird.cn.

Funding

Guangdong Innovation Team Project of General College and University 2023KCXTD024Major Project of Guangzhou National Laboratory GZNL2024A02002National Natural Science Foundation of China 82161138020
6 · The paper itself

Abstract

backgroundNumerous emerging systemic therapies, including monoclonal antibodies and Janus kinase (JAK) inhibitors, are effective for atopic dermatitis (AD). However, their effects on the incidence of airway comorbidities like asthma and allergic rhinitis in AD patients remain unclear. This network meta-analysis evaluates and compares the risks of these adverse events among patients with AD receiving different biologics and systemic JAK inhibitors.

methodsPubMed, Cochrane Library, Embase, and Web of Science were searched for randomized controlled trials (RCTs) evaluating asthma and allergic rhinitis in AD patients receiving JAK inhibitors or biologics, from inception to January 4, 2025. Data synthesis employed a Bayesian network meta-analysis with random-effects modeling, using relative risk (RR) and 95% credible intervals (CI) as effect measures. Meta-regression assessed the impact of study design and participant characteristics on intervention effectiveness. The surface under the cumulative ranking curve (SUCRA) ranked intervention safety profiles, and methodological quality was appraised via the Cochrane ROB 2.0 tool.

resultsA total of 26 randomized clinical trials (13,069 participants) met inclusion criteria, with 9530 receiving JAK inhibitors/biologics and 3540 assigned to placebo. Compared to nemolizumab 90 mg, dupilumab 300 mg (RR = 0.1, 95% CI: 0.01, 0.93) and tralokinumab 150 mg (RR = 0.03, 95% CI: 0, 0.77) were associated with a significantly lower risk of asthma. SUCRA analysis identified ISB 830 600 mg (SUCRA = 8.0%) as the highest for asthma-related adverse events and tralokinumab 150 mg (SUCRA = 95.1%) as the lowest. For allergic rhinitis, abrocitinib 100 mg had the highest adverse event incidence (SUCRA = 10.3%) and dupilumab 200 mg the lowest (SUCRA = 93.8%). Cluster analysis confirmed dupilumab 200 mg as associated with the lowest combined risk of both conditions, while abrocitinib 100 mg had the highest.

conclusionsAmong patients with AD receiving biologics or JAK inhibitors, dupilumab was associated with the lowest risk of asthma and allergic rhinitis in our analysis. Owing to confounding between dose and patient factors (age, disease severity, etc.) in included trials, no specific dose recommendations can be made. These findings warrant confirmation by future large-scale RCTs stratified by age and dose.

trial registrationPROSPERO (CRD42024595904).

Indexed as

AsthmaBiological ProductsDermatitis, AtopicJanus Kinase InhibitorsRhinitis, AllergicHumansRandomized Controlled Trials as TopicRisk AssessmentBiological ProductsJanus Kinase InhibitorsAllergic rhinitisAsthmaAtopic dermatitisBiologicsJAK inhibitor

Identifiers

PMID41652607
PMCPMC12977586

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Registered trials

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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.