Abstract
BACKGROUND: Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by intense itching and lesions that significantly impact patients' quality of life. Abrocitinib, a selective Janus kinase 1 (JAK1) inhibitor, has shown promise in treating AD by targeting inflammatory pathways linked to disease symptoms. This systematic review and meta-analysis evaluates the effectiveness of abrocitinib in reducing lesion severity and pruritus in AD patients. METHODS: A systematic search of PubMed, Embase, Web of Science, and Cochrane Library was conducted on September 19, 2024, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included studies were randomized controlled trials assessing abrocitinib's effects on lesion area and pruritus in AD patients. Data extraction and quality assessment were performed using the Cochrane risk of bias tool. Statistical analyses, including meta-regression and subgroup analysis, were conducted using Stata. Funnel plots were examined to assess publication bias. RESULTS: Five studies met inclusion criteria, with sample sizes ranging from 267 to 837 participants. Abrocitinib significantly improved Investigator's Global Assessment (IGA) and Eczema Area and Severity Index (EASI-75) scores, as well as pruritus scores on the Pruritus Patient Numeric Rating Scale (PP-NRS), compared to placebo (all P < 0.001). A dose-response effect was observed, with higher efficacy at the 200 mg dose. The incidence of treatment-emergent adverse events (TEAEs) was higher in the intervention group, particularly at 200 mg, though no significant difference was noted in serious adverse events (SAEs) between groups. CONCLUSIONS: Abrocitinib is effective in reducing lesion severity and pruritus in AD, with dose-dependent improvements. Despite a higher incidence of manageable TEAEs at 200 mg, no significant increase in SAEs was observed, supporting abrocitinib's safety and efficacy as a treatment for moderate to severe AD. REGISTRATION: CRD420251056272.