Efficacy and Safety of Low-Dose Cyclosporine Relative to Immunomodulatory Drugs Used in Atopic Dermatitis: A Systematic Review and Meta-Analysisopen access
- Authors
- Kim, Kyunghoon; Kim, Mina; Rhee, EunHee; Lee, Mi-Hee; Yang, Hyeon-Jong; Park, Suyeon; Kim, Hwan Soo
- Issue Date
- Feb-2023
- Publisher
- MDPI AG
- Keywords
- atopic dermatitis; cyclosporine A; efficacy
- Citation
- Journal of Clinical Medicine, v.12, no.4
- Journal Title
- Journal of Clinical Medicine
- Volume
- 12
- Number
- 4
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/22382
- DOI
- 10.3390/jcm12041390
- ISSN
- 2077-0383
2077-0383
- Abstract
- Cyclosporine A (CsA) is effective in treating moderate-to-severe atopic dermatitis (AD). This systematic review and meta-analysis aimed to summarize the effectiveness and safety of low-dose (<4 mg/kg) versus high-dose (>= 4 mg/kg) CsA and other systemic immunomodulatory agents in patients with AD. Five randomized controlled trials met the inclusion criteria. The meta-analysis included 159 patients with moderate-to-severe AD who were randomized to receive low-dose CsA, and 165 patients randomized to receive high-dose CsA and other systemic immunomodulatory agents. We found that low-dose CsA was not inferior to high-dose CsA and other systemic immunomodulatory agents in reducing AD symptoms [standard mean difference (SMD) -1.62, 95% confidence interval (CI) -6.47; 3.23]. High-dose CsA and other systemic immunomodulatory agents showed a significantly lower incidence of adverse events [incidence rate ratio (IRR) 0.72, 95% CI 0.56; 0.93], however, after sensitivity analysis, there was no difference between the two groups except for one study (IRR 0.76, 95% CI 0.54; 1.07). Regarding serious adverse events requiring discontinuation of treatment, we observed no significant differences between low-dose CsA and other systemic immunomodulatory agents (IRR 1.83, 95% CI 0.62; 5.41). Our study may justify the use of low-dose CsA rather than high-dose CsA and other systemic immunomodulatory agents in moderate-to-severe AD.
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Collections - College of Medicine > Department of Pediatrics > 1. Journal Articles
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