Abstract: Objective: To investigate the efficacy and safety of Janus kinase inhibitor(abrocitinib, baricitinib, upadacitinib) in the treatment of moderate to severe atopic dermatitis. Methods: Systematic search of the databases PubMed, Cochrane Library, Embase, CNKI and VIP for randomized controlled trials on the efficacy and safety of the above three drugs in the treatment of moderate to severe atopic dermatitis from the time of construction until March 2023. Network Meta-analysis was performed in Stata14.0 and R4.3.2 software, and statistical analysis was performed using relative risk and 95% confidence interval. Results: A total of 17 randomized controlled trials involving 8807 AD patients were included. The results of network meta-analysis showed that the three drugs could improve the symptoms of patients with atopic dermatitis, and the cumulative ranking probability showed that upadacitinib 30 mg had the best efficacy, followed by 15 mg of upadacitinib and 200 mg of abrocitinib. And the proportion of patients achieving EASI-75, vIGA-AD 0/1 improvement and other efficacy evaluation indicators was significantly higher than that of placebo group. However, compared with baricitinib, abrocitinib and upadacitinib cause more treatment-induced adverse events (TEAE). Conclusion: Different doses of abrocitinib, baricitinib and upadacitinib are safe and effective in the treatment of adult and adolescent atopic dermatitis. The 30 mg dose of upadacitinib have a higher short-term efficacy, it is also necessary to pay attention to the possible risk of adverse reactions.

Key words: atopic dermatitis, Janus kinase inhibitor, network meta-analysis