Summary

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• Ztalmy (ganaxolone) is indicated for the treatment of seizures associated with cyclin-dependent kinase-like 5 (CDKL5) deficiency disorder (CDD) in patients 2 years of age and older.
• This summary is based on the review of 17 systematic review(s)/meta-analysis(es). ^[1-17]
• Eczema Area and Severity Index (EASI) Outcomes: High-dose upadacitinib (30 mg) demonstrates the highest efficacy in achieving EASI-75, EASI-90, and EASI-50 across multiple studies. Abrocitinib (200 mg) is effective but generally less so than high-dose upadacitinib, while Dupilumab, lebrikizumab, and tralokinumab show intermediate effectiveness.
• Investigator Global Assessment (IGA) Outcomes: Upadacitinib (30 mg) is most effective in achieving IGA 0/1 responses, with abrocitinib (200 mg) showing significant but slightly lower efficacy. Dupilumab provides moderate results, outperforming baricitinib and tralokinumab.
• Pruritus Numerical Rating Scale (NRS) Outcomes: Upadacitinib (30 mg) leads to the highest improvement in pruritus scores, followed by abrocitinib (200 mg), which outperforms lower doses and other JAK inhibitors.
• Quality of Life Outcomes: Abrocitinib, particularly at the 200 mg dose, significantly improves Dermatology Life Quality Index (DLQI) and Patient Oriented Eczema Measure (POEM) scores.
• High-dose JAK inhibitors, such as upadacitinib (30 mg) and abrocitinib (200 mg), are associated with an increased risk of adverse events (AEs), including headache, acne, elevated blood creatinine phosphokinase, and nausea. Severe adverse events occur more frequently with high-dose JAK inhibitors compared to dupilumab.
• The risk of serious adverse events (SAEs), such as serious infections, non-melanoma skin cancer, major adverse cardiovascular events, and venous thromboembolism, is not significantly increased with JAK inhibitors in short-term studies.
• Both abrocitinib (200 mg) and upadacitinib (30 mg) have higher rates of treatment-emergent adverse events (TEAEs) compared to placebo, with higher incidences observed for these doses relative to lower doses and other JAK inhibitors.
• There is no population types or subgroups information available in the reviewed studies.