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المؤلفDerek K., Chu
المؤلفChu, Alexandro W.L.
المؤلفRayner, Daniel G.
المؤلفGuyatt, Gordon H.
المؤلفYepes-Nuñez, Juan José
المؤلفGomez-Escobar, Luis
المؤلفPérez-Herrera, Lucia C.
المؤلفDíaz Martinez, Juan Pablo
المؤلفBrignardello-Petersen, Romina
المؤلفSadeghirad, Behnam
المؤلفWong, Melanie M.
المؤلفCeccacci, Renata
المؤلفZhao, Irene X.
المؤلفBasmaji, John
المؤلفMacDonald, Margaret
المؤلفChu, Xiajing
المؤلفIslam, Nazmul
المؤلفGao, Ya
المؤلفIzcovich, Ariel
المؤلفAsiniwasis, Rachel N.
المؤلفBoguniewicz, Mark
المؤلفDe Benedetto, Anna
المؤلفCapozza, Korey
المؤلفChen, Lina
المؤلفEllison, Kathy
المؤلفFrazier, Winfred T.
المؤلفGreenhawt, Matthew
المؤلفHuynh, Joey
المؤلفLeBovidge, Jennifer
المؤلفLio, Peter A.
المؤلفMartin, Stephen A.
المؤلفO’Brien, Monica
المؤلفOng, Peck Y.
المؤلفSilverberg, Jonathan I.
المؤلفSpergel, Jonathan M.
المؤلفSmith Begolka, Wendy
المؤلفWang, Julie
المؤلفWheeler, Kathryn E.
المؤلفGardner, Donna D.
المؤلفSchneider, Lynda
تاريخ الإتاحة2023-12-26T08:52:19Z
تاريخ النشر2023-12-31
اسم المنشورJournal of Allergy and Clinical Immunology
المعرّفhttp://dx.doi.org/10.1016/j.jaci.2023.08.030
الرقم المعياري الدولي للكتاب00916749
معرّف المصادر الموحدhttps://www.sciencedirect.com/science/article/pii/S0091674923011132
معرّف المصادر الموحدhttp://hdl.handle.net/10576/50632
الملخصBackgroundAtopic dermatitis (AD) is a common skin condition with multiple topical treatment options, but uncertain comparative effects. ObjectiveWe sought to systematically synthesize the benefits and harms of AD prescription topical treatments. MethodsFor the 2023 American Academy of Allergy, Asthma & Immunology and American College of Allergy, Asthma, and Immunology Joint Task Force on Practice Parameters AD guidelines, we searched MEDLINE, EMBASE, CENTRAL, CINAHL, LILACS, ICTRP, and GREAT databases to September 5, 2022, for randomized trials addressing AD topical treatments. Paired reviewers independently screened records, extracted data, and assessed risk of bias. Random-effects network meta-analyses addressed AD severity, itch, sleep, AD-related quality of life, flares, and harms. The Grading of Recommendations Assessment, Development and Evaluation approach informed certainty of evidence ratings. We classified topical corticosteroids (TCS) using 7 groups—group 1 being most potent. This review is registered in the Open Science Framework (https://osf.io/q5m6s). ResultsThe 219 included trials (43,123 patients) evaluated 68 interventions. With high-certainty evidence, pimecrolimus improved 6 of 7 outcomes—among the best for 2; high-dose tacrolimus (0.1%) improved 5—among the best for 2; low-dose tacrolimus (0.03%) improved 5—among the best for 1. With moderate- to high-certainty evidence, group 5 TCS improved 6—among the best for 3; group 4 TCS and delgocitinib improved 4—among the best for 2; ruxolitinib improved 4—among the best for 1; group 1 TCS improved 3—among the best for 2. These interventions did not increase harm. Crisaborole and difamilast were intermediately effective, but with uncertain harm. Topical antibiotics alone or in combination may be among the least effective. To maintain AD control, group 5 TCS were among the most effective, followed by tacrolimus and pimecrolimus. ConclusionsFor individuals with AD, pimecrolimus, tacrolimus, and moderate-potency TCS are among the most effective in improving and maintaining multiple AD outcomes. Topical antibiotics may be among the least effective.
اللغةen
الناشرElsevier
الموضوعAtopic dermatitis (eczema)
topical treatments (therapy)
topical corticosteroids (steroids)
topical calcineurin inhibitors (pimecrolimus, tacrolimus)
topical phosphodiesterase-4 (PDE-4) inhibitors (crisaborole, difamilast, lotamilast, roflumilast)
topical Janus kinase (JAK) inhibitors (ruxolitinib, delgocitinib)
patient-important outcomes (eczema severity, intensity, itch, sleep, quality of life, flares or flare-ups or exacerbations)
disease severity
network meta-analysis (comparative effects)
induction of remission and maintenance of remission (reactive or proactive therapy)
العنوانTopical treatments for atopic dermatitis (eczema): Systematic review and network meta-analysis of randomized trials
النوعArticle
الصفحات1493-1519
رقم العدد6
رقم المجلد152
Open Access user License http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.accessType Open Access


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