An updated meta-analysis depicted that both Janus kinase (JAK1) inhibitors (Upadacitinib and Abrocitinib) appeared to have therapeutic benefits, however, Upadacitinib was superior to Abrocitinib in treating atopic dermatitis. For moderate-to-severe atopic dermatitis, Ying Zhang et al. compared the safety and effectiveness of JAK1 inhibitors.

Embase, Medline, Web of Science, and Cochrane databases were explored by two independent reviewers. Data from phase two and three randomized controlled trials (RCTs) were also incorporated. The percentage of respondents to the Investigator's Global Assessment (IGA) and Eczema Area and Severity Index-75 (EASI-75) were the major outcomes ascertained. Overall, 4634 moderate-to-severe atopic dermatitis participants from eight RCTs were included.

Both JAK1 inhibitors appeared to have therapeutic benefits. However, in IGA responders (at the end of therapy) and EASI-75 responders (following 2 weeks of intervention), the 200 mg Abrocitinib group exhibited less effectiveness compared to the 30 mg Upadacitinib group. The risks of headache (6.3%) and acne (9.0%) were substantially greater in both JAK1 inhibitor groups. Abrocitinib revealed considerably greater risks of nausea (9.6%).

Upadacitinib displayed substantially higher risks of nasopharyngitis (9.7%) and upper respiratory tract infection (7.6%). JAK1 inhibitors show favorable effectiveness in atopic dermatitis. Rapid and dose-dependent response with noticeably elevated risks of headache and acne were noted. Individuals with atopic dermatitis are advised to use oral 30 mg Upadacitinib QD instead of oral 200 mg Abrocitinib QD. An alternate dose regimen of oral 15 mg Upadacitinib QD may be used in the case of treatment-emergent side effects.