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SYSTEMATIC REVIEW article
Front. Allergy
Sec. Skin Allergy
Volume 5 - 2024 |
doi: 10.3389/falgy.2024.1486271
Baricitinib as Monotherapy and with Topical Corticosteroids in Moderate-to-Severe Atopic Dermatitis: A Systematic Review and Meta-Analysis of Dose-Response
Provisionally accepted- 1 Liaquat University of Medical & Health Sciences, Jamshoro, Sindh, Pakistan
- 2 Avicenna Tajik State Medical University, Dushanbe, Tajikistan
- 3 Ghulam Muhammad Mahar Medical College, Sukkur, Sindh, Pakistan
- 4 Dow Medical College, Dow University of Health Sciences, Karachi, Punjab, Pakistan
- 5 Nishtar Medical College, Multan, Punjab, Pakistan
- 6 shaheed mohtarma benazir bhutto medical college lyari, Karachi, Punjab, Pakistan
- 7 Jinnah Sindh Medical University, Karachi, Sindh, Pakistan
- 8 Patan Academy of Health Sciences, Patan, Nepal
Introduction: Atopic dermatitis (AD) is a chronic inflammatory skin disorder that affects millions worldwide, presenting challenges in managing symptoms and quality of life. Current treatments include topical corticosteroids (TCS), but novel approaches, such as Janus kinase (JAK) inhibitors, show promise. Baricitinib, a selective JAK1 and JAK2 inhibitor, targets cytokines involved in AD and offers potential benefits beyond traditional therapies.A systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to evaluate the efficacy and safety of baricitinib in treating moderate-to-severe AD. We followed PRISMA guidelines and assessed data from PubMed, Cochrane Central, ScienceDirect, and ClinicalTrials.gov up to August 2024. The analysis included trials comparing baricitinib to placebo, with or without TCS, evaluating outcomes such as Investigator's Global Assessment (IGA) scores, Eczema Area and Severity Index (EASI) scores, and safety profiles.Results: Six RCTs involving 2,595 participants met the inclusion criteria. Baricitinib demonstrated significant improvements in IGA scores, EASI scores, Dermatology Life Quality Index (DLQI), and other outcome measures compared to placebo. The efficacy was consistent across different dosages (1 mg, 2 mg, 4 mg) and whether baricitinib was used with or without TCS. Safety analyses revealed a significant increase in treatment-emergent adverse events (TEAEs), particularly with the 2 mg and 4 mg dosages and with TCS.Baricitinib, both alone and in combination with TCS, significantly improves symptoms and quality of life in patients with moderate-to-severe AD, with efficacy consistent across dosages. The safety profile is overall acceptable, though a significant increase in TEAEs was observed, particularly with higher dosages and when used with TCS. Ongoing monitoring of TEAEs is recommended, and future trials with longer follow-up periods are suggested to better understand long-term outcomes.
Keywords: atopic dermatitis, Baricitinib, JAK inhibitors, Eczema Area and Severity Index, Treatment-emergent adverse events
Received: 25 Aug 2024; Accepted: 31 Oct 2024.
Copyright: Ā© 2024 ALMOGHAYER, Soomro, Dev, Turesh, Kumar, Kumar, Meghjiani, Lamiya Mir, Hassaan, Qureshi, Kumar, Ashraf, Deepak, Siddiq, Haseeb and Chaulagain. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Aayush Chaulagain, Patan Academy of Health Sciences, Patan, Nepal
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