2SPD-012 Comparative efficacy of abrocitinib, baricitinib and upadacitinib in monotherapy for the treatment of atopic dermatitis
Bibliographic record
Abstract
Background and Importance Several oral drugs for atopic dermatitis have been approved in recent years. However, there are no studies that directly compare these treatments. Aim and Objectives 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. Material and Methods 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. Results 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). Conclusion and Relevance 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. Conflict of Interest No conflict of interest
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.006 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.026 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".