Comparative efficacy of targeted systemic therapies for moderate-to-severe atopic dermatitis: a network meta-analysis of phase 3-4 randomized trials.
Mei Xiong, QiaoLi Gao, Xiaoxia Duan
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In 30 seconds
This Bayesian network meta-analysis compared approved targeted systemic therapies for adults with moderate-to-severe atopic dermatitis, using phase 3–4 randomized trials published through July 29, 2025. It included 27 reports covering 33 trials and 16,334 participants, and assessed EASI-75, EASI-90, IGA 0/1, and NRS response. Upadacitinib 30 mg ranked highest in probability of achieving each evaluated efficacy outcome. Comparisons found no significant differences between dupilumab 300 mg and stapokibart 300 mg, or between ivarmacitinib 8 mg and upadacitinib 15 mg; most relative estimates relied on indirect comparisons.
Key findings
- Across EASI-75, EASI-90, IGA 0/1, and NRS response, upadacitinib 30 mg had the highest probability of achieving each endpoint.
- No significant differences were observed between dupilumab 300 mg and stapokibart 300 mg.
- No significant differences were observed between ivarmacitinib 8 mg and upadacitinib 15 mg.
Why it matters
The analysis brings together trial evidence to compare efficacy across approved systemic targeted therapies when direct comparisons are limited. Its rankings may help contextualize the relative likelihood of clinical responses, but they should not be interpreted as definitive proof of superiority because the estimates are primarily indirect.
What to keep in mind
The findings are derived primarily from indirect comparisons; the authors state that head-to-head randomized trials are needed to confirm relative effectiveness.