OBJECTIVE: To systematically evaluate the efficacy and safety of dupilumab in the treatment of adults with moderate to severe atopic dermatitis

so as to provide evidence-based reference for clinical treatment. METHODS: PubMed

Embase

the Cochrane Library and CNKI were retrieved to collect the randomized controlled trial of dupilumab in the treatment of adults with moderate to severe atopic dermatitis（the study group received dupilumab

while the control group was given placebo）. The retrieval time was from the establishment of the database to Jun. 2022. RevMan 5.3 software was used for Meta-analysis. RESULTS: Totally 10 randomized controlled trials were enrolled

including 3 383 patients. Proportion of patients in the study group with eczema area and severity index ≥75% of baseline remission（EASI75） were significantly higher than control group（total: RR=3.01

95%CI=2.62-3.46

P<0.000 01; 300 mg

qw: RR=2.91

95%CI=2.38-3.55

P<0.000 01; 300 mg

q2w: RR=3.16

95%CI=2.56-3.89

P<0.000 01）

proportion of patients in the study group with eczema area and severity index ≥50% of baseline remission（EASI50） were significantly higher than control group（total: RR=2.43

95%CI=2.24-2.64

P<0.000 01; 300 mg

qw: RR=2.32

95%CI=2.09-2.59

P<0.000 01; 300 mg

q2w: RR=2.58

95%CI=2.27-2.93

P<0.000 01）

with statistically significant differences. Meanwhile

compared with the proportion of patients in the study group with IGA score of 0 or 1 points（clear or almost clear）

the proportion of patients in the study group whose score of pruritus index（NRS） decreased by more than 3 points and other six effectiveness indicators

the study group was significantly better than that of control group

with statistically significant differences（P<0.05）. Through the comparative analysis of 300 mg qw and 300 mg q2w

there was no significant difference in each effectiveness index between two administration methods（P>0.05）. In terms of safety

the incidence of serious adverse reactions and skin allergy in the study group was significantly lower than that in the control group

and the incidence of injection site reaction

headache and oral herpes in the study group was significantly higher than that in the control group

with statistically significant differences（P<0.05）. There was no significant difference in the incidence of total adverse drug reactions

upper respiratory tract reaction and other safety indicators between the study group and the control group（P>0.05）. There was no significant difference between 300 mg qw and 300 mg q2w in various safety indicators（P>0.05）. CONCLUSIONS: The efficacy of dupilumab in the treatment of adults with moderate to severe atopic dermatitis is significant

and the adverse drug reactions are mild and tolerable.