Efficacy and safety of abrocitinib for the treatment of adolescents and adults with moderate-to-severe atopic dermatitis: update of a living systematic review and meta-analysis

Despite extensive research on biological therapies for atopic dermatitis (AD), recent clinical trials of the Janus kinase inhibitor 1, abrocitinib, have provided more definitive evidence regarding its efficacy and safety in treating AD. To conduct a living systematic review and meta-analysis to evaluate the efficacy and safety of abrocitinib in adolescents and adults with moderate-to-severe AD. The databases of PubMed, Embase, Cochrane Library and clinical trial registries were searched from inception of the databases to July 11, 2023. Only randomized controlled trials assessing the efficacy and safety of abrocitinib in individuals with moderate-to-severe AD were included in the meta-analysis. Twelve studies involving a total of 5,644 participants aged 12 years or older were included in the analysis. The pooled results revealed a significantly higher proportion of patients achieving Investigator Global Assessment response (RR = 3.52, 95% CI: 2.78 to 4.46), Eczema Area and Severity Index response (RR = 3.35, 95% CI: 2.54 to 4.41), Peak Pruritus Numeric Rating Scale response (RR = 2.54, 95% CI: 1.95 to 3.30), and Patient-Oriented Eczema Measure response (abrocitinib 100-mg group: -4.25, 95% CrI: -5.24 to -3.27; abrocitinib 200-mg group: -7.69, 95% CrI: -8.39 to -6.99) compared to the placebo group. Additionally, there was no significant differences in adverse events between the abrocitinib and placebo groups. Abrocitinib demonstrates a favourable safety profile and robust efficacy in treating moderate-to-severe AD compared to placebo. The 200-mg dose regimen appears to be more effective than the 100-mg dose regimen for the treatment of AD.