Systematic review of Crisaborole Ointment in treatment of atopic dermatitis
Objective To evaluate the efficacy and safety of Crisaborole Ointment in the treatment of atopic dermatitis.Methods Randomized controlled trials(RCT)on the treatment of atopic dermatitis with Crisaborole ointment published in databases of Cochrane Library,Embase,PubMed,CNKI,Wanfang Database,VIP,SinoMed and Yiigle were electronically searched from database establishment until January 30,2024.Two researchers independently screened and extracted information,assessed bias risk using the ROB-2 tool,conducted Meta-analysis using Review Manager 5.3,and evaluated the quality of evidence using the GRADE system.Results A total of 11 RCTs were involved with 2 789 AD patients.Meta-analysis showed that compared to placebo treatment,Crisaborole Ointment increased the ISGA success rate[RR=1.52,95%CI(1.28,1.80),P<0.000 01]and relief rate[RR=1.43,95%CI(1.27,1.62),P<0.000 01],decreased EASI scores[MD=-2.44,95%CI(-4.15,-0.73),P=0.005],relieved itching,prolonged flare-free time,and reduced relapse frequency.Compared to positive controls,it demonstrated a higher disease efficacy cure rate[RR=1.80,95%CI(1.33,2.43),P=0.000 1],improving quality of life.When compared to the use of positive drug,combination therapy had a higher disease efficacy cure rate[RR=1.23,95%CI(1.03,1.48),P=0.02],higher EASI score change value[MD=-2.11,95%CI(-3.13,-1.10),P<0.000 1],relieved itching,and improved quality of life.In terms of safety,adverse reactions were mainly local reactions at the administration site,such as irritation,pain,itching,discoloration,and abnormal sensations,mostly mild to moderate,with a good prognosis.Conclusion Crisaborole Ointment can alleviate the severity of AD,relieve itching,improve the quality of life,and long-term maintenance therapy with a low dose can reduce AD recurrence after the condition stabilizes.It is well-tolerated in both children and adults,but clinicians should pay attention to abnormal local reactions at the administration site during clinical use.