2SPD-012 Comparative efficacy of abrocitinib, baricitinib and upadacitinib in monotherapy for the treatment of atopic dermatitis
Notice bibliographique
Résumé
<h3>Background and Importance</h3> Several oral drugs for atopic dermatitis have been approved in recent years. However, there are no studies that directly compare these treatments. <h3>Aim and Objectives</h3> To establish, through an indirect comparison (IC) against placebo, whether abrocitinib, baricitinib and upadacitinib can be considered equivalent alternatives in efficacy for the treatment of atopic dermatitis, when used as monotherapy. <h3>Material and Methods</h3> A PubMed search was performed for pivotal clinical trials (CTs) of abrocitinib (200 mg/24h), baricitinib (4 mg/24h), and upadacitinib (30 mg/24h) for atopic dermatitis, as monotherapy. The main variable for comparison was the results of the EASI75 (Eczema Area and Severity Index) at week 16 after the start of treatment. With the results of the EASI75 (%), the relative risk (RR) compared to placebo was calculated. Finally, with these values, an IC of these drugs was performed using the Bucher method (ITC calculator, Indirect Treatment Comparisons, of the Canadian Agency for Health Technology Assessment). The results were analysed, seeing if there were statistically significant differences between these three drugs. <h3>Results</h3> Five CTs were found, one with abrocitinib, two with baricitinib (CTB1, CTB2) and upadacitinib (CTU1, CTU2), all of them compared to placebo as a common comparator. All the studies presented a similar methodology. However, in the CT of abrocitinib, patients under 18 years of age were not included, while in upadacitinib (13.5%) and baricitinib (22%) they were. Moreover, in the abrocitinib CT the EASI75 is measured at 12 weeks while in the others at 16 weeks. These limitations for IC were eventually accepted. After applying the Bucher method, the following results were obtained: OR (abrocitinib 200 mg vs baricitinib 4 mg) 0,53 [IC 95% 0,24–1,18]; p=0,12 (in CTB1) and 0,65 [IC 95% 0,27–1,54]; p=0,32 (in CTB2), OR (abrocitinib 200 mg vs upadacitinib 30 mg) 0,92 [IC 95% 0,46–1,82]; p=0,81 (in CTU1) and 1,04 [IC 95% 0,52–2,08];p=0,92 (in CTU2), OR (baricitinib 4 mg CTB1 vs upadacitinib 30 mg) 1,73 [IC 95% 0,98–3,07]; p=0,06 (in CTU1) and 1,95 [IC 95% 1,08–3,52]; p=0,03 (in CTU2), OR (baricitinib 4 mg CTB2 vs upadacitinib 30 mg) 1,42 [IC 95% 0,73–2,73]; p=0,30 (in CTU1) and 1,6 [IC 95% 0,81–3,13]; p=0,17 (in CTU2). <h3>Conclusion and Relevance</h3> According to the results obtained, it could be that Upadacitinib 30 mg presented greater efficacy than Baricitinib 4 mg as it is the only IC that has given a statistically significant difference. However, due to the aforementioned limitations, these results should be taken with caution and safety and efficiency criteria should also be taken into account. <h3>Conflict of Interest</h3> No conflict of interest
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
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