PDF(Pubmed)
Abstract：
UNASSIGNED: Atopic dermatitis (AD) patients have an increased risk of herpes zoster (HZ). The relationship of dupilumab, tralokinumab, upadacitinib, and abrocitinib to HZ incidence in AD patients remains unclear.
UNASSIGNED: To evaluate and compare the incidence and risk of HZ among patients with moderate to severe atopic dermatitis treated with advanced systemic therapies.
UNASSIGNED: Systematic searches were conducted in Ovid Medline and Embase. The primary outcome was incidence of HZ in patients with moderate to severe AD receiving placebo or the aforementioned treatments. A frequentist random-effects NMA was conducted with odds ratio.
UNASSIGNED: Our search identified 16 trials comprising 10,689 patients. Upadacitinib was associated with a dose-dependent increase in the incidence of HZ compared to placebo (OR = 2.55 [1.09, 5.95] and (OR = 4.29 [1.89, 9.74], respectively) and compared to various dupilumab doses (OR = 4.48 [1.29, 15.57], 3.61 [1.28, 10.18] and 7.54 [2.21, 25.68], 6.09 [2.24, 16.52], respectively). Upadacitinib 30 mg was associated with a higher incidence of HZ when compared to upadacitinib 15 mg (OR = 1.68 [1.19, 2.38]). Abrocitinib 200 mg was associated with a higher increase in HZ compared to placebo (OR = 3.34 [1.34, 8.31]). According to SUCRA ranks, both JAK-1 inhibitors had a higher cumulative incidence of HZ compared to dupilumab.
UNASSIGNED: JAK-1 inhibitors are associated with a significantly higher incidence of HZ compared to dupilumab and placebo. Our results suggest that recombinant HZ vaccination should be highly considered for all adult patients prior to starting oral JAK-1 inhibitors.
UNASSIGNED: To evaluate and compare the incidence and risk of HZ among patients with moderate to severe atopic dermatitis treated with advanced systemic therapies.
UNASSIGNED: Systematic searches were conducted in Ovid Medline and Embase. The primary outcome was incidence of HZ in patients with moderate to severe AD receiving placebo or the aforementioned treatments. A frequentist random-effects NMA was conducted with odds ratio.
UNASSIGNED: Our search identified 16 trials comprising 10,689 patients. Upadacitinib was associated with a dose-dependent increase in the incidence of HZ compared to placebo (OR = 2.55 [1.09, 5.95] and (OR = 4.29 [1.89, 9.74], respectively) and compared to various dupilumab doses (OR = 4.48 [1.29, 15.57], 3.61 [1.28, 10.18] and 7.54 [2.21, 25.68], 6.09 [2.24, 16.52], respectively). Upadacitinib 30 mg was associated with a higher incidence of HZ when compared to upadacitinib 15 mg (OR = 1.68 [1.19, 2.38]). Abrocitinib 200 mg was associated with a higher increase in HZ compared to placebo (OR = 3.34 [1.34, 8.31]). According to SUCRA ranks, both JAK-1 inhibitors had a higher cumulative incidence of HZ compared to dupilumab.
UNASSIGNED: JAK-1 inhibitors are associated with a significantly higher incidence of HZ compared to dupilumab and placebo. Our results suggest that recombinant HZ vaccination should be highly considered for all adult patients prior to starting oral JAK-1 inhibitors.
摘要：
■特应性皮炎（AD）患者患带状疱疹（HZ）的风险增加。dupilumab的关系，tralokinumab,upadacitinib,和abrocitinib至HZ在AD患者中的发病率尚不清楚。
■评估和比较接受高级全身疗法治疗的中度至重度特应性皮炎患者中HZ的发生率和风险。
■在OvidMedline和Embase进行了系统搜索。主要结果是接受安慰剂或上述治疗的中度至重度AD患者的HZ发生率。以比值比进行频率随机效应NMA。
■我们的搜索确定了16项试验，包括10,689名患者。与安慰剂相比，Upadacitinib与HZ发病率的剂量依赖性增加相关（OR=2.55[1.09,5.95]和（OR=4.29[1.89,9.74]，分别）并与各种dupilumab剂量进行比较（OR=4.48[1.29，15.57]，3.61[1.28,10.18]和7.54[2.21,25.68]，6.09[2.24,16.52],分别)。与15mgupadacitinib相比，30mgupadacitinib的HZ发病率更高（OR=1.68[1.19,2.38]）。与安慰剂相比，200mg阿布西替尼与HZ的增加更高（OR=3.34[1.34,8.31]）。根据SUCRA排名，两种JAK-1抑制剂的HZ累积发生率均高于dupilumab.
■与dupilumab和安慰剂相比，JAK-1抑制剂与HZ的发生率显着升高相关。我们的结果表明，在开始口服JAK-1抑制剂之前，应高度考虑所有成年患者的重组HZ疫苗接种。
■评估和比较接受高级全身疗法治疗的中度至重度特应性皮炎患者中HZ的发生率和风险。
■在OvidMedline和Embase进行了系统搜索。主要结果是接受安慰剂或上述治疗的中度至重度AD患者的HZ发生率。以比值比进行频率随机效应NMA。
■我们的搜索确定了16项试验，包括10,689名患者。与安慰剂相比，Upadacitinib与HZ发病率的剂量依赖性增加相关（OR=2.55[1.09,5.95]和（OR=4.29[1.89,9.74]，分别）并与各种dupilumab剂量进行比较（OR=4.48[1.29，15.57]，3.61[1.28,10.18]和7.54[2.21,25.68]，6.09[2.24,16.52],分别)。与15mgupadacitinib相比，30mgupadacitinib的HZ发病率更高（OR=1.68[1.19,2.38]）。与安慰剂相比，200mg阿布西替尼与HZ的增加更高（OR=3.34[1.34,8.31]）。根据SUCRA排名，两种JAK-1抑制剂的HZ累积发生率均高于dupilumab.
■与dupilumab和安慰剂相比，JAK-1抑制剂与HZ的发生率显着升高相关。我们的结果表明，在开始口服JAK-1抑制剂之前，应高度考虑所有成年患者的重组HZ疫苗接种。
