In two systematic reviews and network meta-analyses published in The Journal of Allergy and Clinical Immunology, researchers from McMaster University have identified the most effective treatments for atopic dermatitis – the skin condition known as eczema.
The first study addressed topical treatments for mild to moderate eczema. Led by Derek Chu, assistant professor in the Department of Medicine at McMaster, researchers compared patient-important outcomes and assessed the certainty of the evidence among 68 topical therapies evaluating 43,123 participants across 219 trials. Pimecrolimus, tacrolimus, and moderate-potency topical corticosteroids are among the most effective in improving and maintaining multiple eczema outcomes. Topical antibiotics alone or in combination may be among the least effective.
The second study addressed advanced systemic treatments for moderate to severe eczema. Chu’s team compared patient-important outcomes and assessed the certainty of the evidence among 75 systemic treatments evaluating 28,686 participants across 149 randomized controlled trials. High-dose upadacitinib was among the most effective treatment in improving multiple outcomes; however, it was among the most harmful in increasing adverse events. Dupilumab, lebrikizumab, and tralokinumab were of intermediate effectiveness and among the safest.
The researchers say the findings transparently present the full menu of treatment options for atopic dermatitis to inform optimal eczema management among patients, caregivers, and clinicians.
To speak with Derek Chu, contact him at [email protected]