Baricitinib in the treatment of atopic dermatitis: a systematic review of randomized controlled trials

Aim
The aim of the study was to evaluate the efficacy and safety of baricitinib in treating atopic dermatitis (AD) and to provide evidence-based guidance for clinical use.

Material and methods
Randomized controlled trials (RCTs) of baricitinib (experimental group) versus placebo (control group) were searched in PubMed and Cochrane Library databases by computer, and the search period was from the establishment of the database to December 2024. After screening the literature and extracting data, the quality of the included studies was assessed using the bias assessment tools recommended in the Cochrane Handbook for Systematic Reviews 5.1.0. Meta-analysis was conducted using RevMan 5.4 software, and sensitivity analysis and publication bias analysis were performed using Stata software.

Results
A total of 6 studies were included, comprising 7 RCTs with a total of 2966 patients. The results of the meta-analysis showed that the EASI 50 or EASI 75 in the experimental group (OR = 2.68, 95% CI (2.15, 3.34), p < 0.00001), vIGA-AD (OR = 2.67, 95% CI (1.97, 3.63), p < 0.00001), EASI 90 (OR = 2.58, 95% CI (1.83, 3.62), p < 0.00001), SCORAD 75 (OR = 3.99, 95% CI (2.47, 6.45), p < 0.00001), and NRS ≥ 4 (OR = 2.45, 95% CI (1.90, 3.17), p < 0.00001) were all significantly higher than those in the control group. There was no statistically significant difference in the incidence of adverse drug events, serious adverse events, nasopharyngitis, upper respiratory tract infections, diarrhoea, etc. between the two groups of patients (p > 0.05). Subgroup analysis results showed that there were significant differences in treatment effects between the 1 mg experimental group and the 2 mg experimental group, as well as between the 2 mg experimental group and the 4 mg experimental group. The results of the sensitivity analysis and publication bias analysis indicated that the findings of this study are robust and there is a low possibility of publication bias.

Conclusions
Baricitinib demonstrates good efficacy and safety in the treatment of AD.