Abstract: Objective: To compare the clinical efficacy and safety of dupilumab and abrocitinib in the treatment of atopic dermatitis. Methods: Databases including PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Database were searched. All randomized controlled trials published from the database establishment to April 2025, in which used dupilumab or abrocitinib was used for the treatment of atopic dermatitis with placebo as the control, were collected. A meta-analysis was conducted with the Investigator's Global Assessment (IGA), Eczema Area and Severity Index (EASI), and Pruritus Numerical Rating Scale (PP-NRS) as the evaluation indicators. Results: A total of 4 studies were included. The IGA results showed that abrocitinib 200 mg was superior to dupilumab 300 mg (RR=1.35, 95% CI:1.20-1.52) and abrocitinib 100 mg (RR=1.40, 95% CI:1.16-1.68), respectively. The EASI75 results showed that abrocitinib 200 mg was superior to dupilumab 300 mg (RR=1.13, 95% CI:1.05-1.21). The PP-NRS results showed that abrocitinib 200 mg was superior to dupilumab 300 mg (RR=1.12, 95% CI:1.02-1.23) and superior to abrocitinib 100 mg (RR=0.78, 95% CI:0.65-0.93). The results of the incidence of serious adverse reactions showed that there was no significant difference between abrocitinib 200 mg and dupilumab 300 mg (RR=0.92, 95% CI:0.38-2.25). Conclusion: Abrocitinib is superior to dupilumab in the clinical efficacy for the treatment of atopic dermatitis, and its safety is comparable to that of dupilumab.

Key words: dupilumab, abrocitinib, atopic dermatitis, meta-analysis