Atopic dermatitis and skin diseaseEfficacy and safety of systemic treatments for moderate-to-severe atopic dermatitis: A systematic review
Section snippets
Methods
We conducted a systematic review on the efficacy and safety of immunomodulating systemic treatments (further noted as “systemics”) for moderate-to-severe AD.
Results of the literature search
Of the 925 references retrieved by using the systematic search, 34 RCTs11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44 were selected for review, including a total of 1653 patients (see Fig E1 in this article's Online Repository at www.jacionline.org).
Study characteristics
Twelve different types of systemic treatments for moderate-to-severe AD were investigated.
Fourteen RCTs evaluated CsA.∗
Discussion
This systematic review provides an evidence-based treatment algorithm for patients with moderate-to-severe AD. By ranking the quality of evidence based on the GRADE approach45 and by taking into account the efficacy and safety shown for short-term (and long-term) use and the number of participants, this review extends previous research and guidelines in which less specific treatment recommendations were made based on expert opinion46 or less systematic approaches, such as the Goodman method47
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Cited by (0)
Disclosure of potential conflict of interest: P. I. Spuls is the coauthor of the MACAD trial included in this review, has consultant arrangements for Novartis, and is the principal investigator of the Department for Clinical Trials with Pharma. J. Schmitt has consultant arrangements with Novartis and has grants/grants pending with Novartis, Abbott, MSD, and Wyeth. The rest of the authors declare that they have no relevant conflicts of interest.