- According to this meta-analysis, compared with respective placebos, cyclosporine or dupilumab bests methotrexate or azathioprine for patients with atopic dermatitis.
Why this matters
- Few trials have assessed the relative efficacy of systemic immunomodulatory treatments for atopic dermatitis.
- Higher-dose cyclosporine or a dupilumab regimen is similarly effective at clearing clinical signs of atopic dermatitis:
- Cyclosporine vs placebo, standardized mean difference (SMD): −1.1 (95% credible interval [CI], −1.7 to −0.5; low certainty).
- Dupilumab vs placebo, SMD: −0.9 (95% CI, −1.0 to −0.8; high certainty).
- Cyclosporine and dupilumab performed better vs their respective placebos than:
- Methotrexate vs placebo, SMD: −0.6 (95% CI, −1.1 to 0.0; low certainty).
- Azathioprine vs placebo, SMD, −0.4 (95% CI, −0.8 to −0.1; low certainty).
- Meta-analysis of data from 39 trials with 6360 patients examining 20 medications, each vs its respective placebo.
- Funding: UK National Institute for Health Research; Eczema Society of Canada; Academic Health Science Centres of Ontario.
- Heterogeneity among included studies.
- Short trial duration for most included studies.