Comparative efficacy of pediatric atopic dermatitis treatments: a network meta-analysis highlighting dupilumab and pimecrolimus for SCORAD and EASI improvement
Abstract
Background: Atopic Dermatitis (AD) in children is a common chronic skin condition characterized by dry, itchy and inflamed skin. Various treatments have been applied in the management of AD in children, but the differences in efficacy of different treatment options have not been systematically summarized. The aim of this study was to compare the efficacy of different treatments for atopic dermatitis in children by network meta-analysis.
Methods: We conducted a systematic literature search to select randomized controlled trials (RCTs) that met the inclusion criteria. Databases included PubMed, EMBASE, Cochrane Library, and Web of Science, with a March 10, 2025, search deadline. Certainty of evidence was graded using the CINeMA tool, and risk of bias was assessed using risk of bias 2.0. The efficacy of different treatment regimens was compared using Bayesian network meta-analysis with R software. The primary outcome indicators were the SCORAD (Clinical Score for Atopic Dermatitis) and EASI (Atopic Dermatitis Area and Severity Index) scores.
Results: Thirty-two randomized controlled trials (n=3961) were included. Meta-analysis showed Dupilumab was more effective than Melatonin, Probiotics, SCG, Synbiotic, and Vitamin D for SCORAD. Cumulative probability rankings indicated Dupilumab (96.0%), Tralokinumab (86.8%), and PEC (69.2%) as the top treatments. For EASI, Pimecrolimus, Dupilumab, and Nemolizumab were superior to Probiotics, with Pimecrolimus showing the highest efficacy…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 3,961 participants or records.
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