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Clinicians

We have performed a network meta-analysis which is a research technique that combines data across clinical trials to give comparisons for all medications, including those that have never been compared directly. This tool presents the results of our analysis on systemic treatments for atopic dermatitis. Get started by selecting whether you want to see results for children or adults. This page was last updated on March 16, 2022.

View treatment results for:

Abrocitinib 100mg
Price:
Very expensive. Prices and insurance coverage vary widely between jurisdictions and do not include other costs such as physician visits.
Description:
This is a Janus Kinase Inhibitor medication taken orally (pills) once daily
Side Effects:
Abrocitinib has been associated with an increased risk of nausea, headache, acne and herpes simplex and herpes zoster (shingles) infections.Tofacitinib, another Janus Kinase (JAK) inhibitor used to treat arthritis, has been associated with increased serious infection, cancer, clotting and heart disease risk. While these risks have not been demonstrated with JAK inhibitors used to treat eczema, clinicians and patients should be aware of these risks.
Availability:
This medication is approved for use in people aged 12 and older with eczema in many countries.
Other Notes:
Insurance coverage for this medication is highly variable from place-to-place and plan-to-plan. In most European countries abrocotinib can only be prescribed if patients have already tried other systemic medications, or if other medications cannot be used.
Click here for additional information and patient handouts from the Medicines & Healthcare Products Regulatory Agency.
Abrocitinib 200mg
Price:
Very expensive. Prices and insurance coverage vary widely between jurisdictions and do not include other costs such as physician visits.
Description:
This is a Janus Kinase Inhibitor medication taken orally (pills) once daily
Side Effects:
Abrocitinib has been associated with an increased risk of nausea, headache, acne and herpes simplex and herpes zoster (shingles) infections.Tofacitinib, another Janus Kinase (JAK) inhibitor used to treat arthritis, has been associated with increased serious infection, cancer, clotting and heart disease risk. While these risks have not been demonstrated with JAK inhibitors used to treat eczema, clinicians and patients should be aware of these risks.
Availability:
This medication is approved for use in people aged 12 and older with eczema in many countries.
Other Notes:
Insurance coverage for this medication is highly variable from place-to-place and plan-to-plan. In most European countries abrocotinib can only be prescribed if patients have already tried other systemic medications, or if other medications cannot be used.
Click here for additional information and patient handouts from the Medicines & Healthcare Products Regulatory Agency.
Azathioprine
Price:
Inexpensive. Prices and insurance coverage vary widely between jurisdictions and do not include other costs such as physician visits and lab monitoring.
Description:
This medication is taken as pills once or twice daily. An oral solution is also available for children.
Side Effects:
This medication works by suppressing the immune system, so it can increase rates of infections and, potentially, cancers if taken for longer periods of time. Other possible side effects include severe allergic reactions, liver or pancreas abnormalities and low blood counts.
Availability:
This medication is not specifically approved for eczema, but it is available in many countries "off-label".
Other Notes:
Before taking this medication and while on it, you will need to have regular blood tests to monitor for side effects.
Click here for additional information and patient handouts from the UK National Eczema Society.
Baricitinib 2mg
Price:
Very expensive. Prices and insurance coverage vary widely between jurisdictions and do not include other costs such as physician visits.
Description:
This is a Janus Kinase Inhibitor medication taken orally (pills) once daily
Side Effects:
Baricitinib has been associated with an increased risk of upper respiratory tract infections, increase in cholesterol, high platelets, nausea and abdominal pain, herpes virus infections, and acne. Tofacitinib, another Janus Kinase (JAK) inhibitor used to treat arthritis, has been associated with increased serious infection, cancer, clotting and heart disease risk. While these risks have not been demonstrated with JAK inhibitors used to treat eczema, clinicians and patients should be aware of these risks.
Availability:
This medication is approved for use in people aged 18 and older with eczema in many countries.
Other Notes:
Insurance coverage for this medication is highly variable from place-to-place and plan-to-plan. In most European countries baricitinib can only be prescribed if patients have already tried other systemic medications, or if other medications cannot be used.
Click here for additional information and patient handouts from the Medicines & Healthcare Products Regulatory Agency.
Baricitinib 4mg
Price:
Very expensive. Prices and insurance coverage vary widely between jurisdictions and do not include other costs such as physician visits.
Description:
This is a Janus Kinase Inhibitor medication taken orally (pills) once daily
Side Effects:
Baricitinib has been associated with an increased risk of upper respiratory tract infections, increase in cholesterol, high platelets, nausea and abdominal pain, herpes virus infections, and acne. Tofacitinib, another Janus Kinase (JAK) inhibitor used to treat arthritis, has been associated with increased serious infection, cancer, clotting and heart disease risk. While these risks have not been demonstrated with JAK inhibitors used to treat eczema, clinicians and patients should be aware of these risks.
Availability:
This medication is approved for use in people aged 18 and older with eczema in many countries.
Other Notes:
Insurance coverage for this medication is highly variable from place-to-place and plan-to-plan. In most European countries baricitinib can only be prescribed if patients have already tried other systemic medications, or if other medications cannot be used.
Click here for additional information and patient handouts from the Medicines & Healthcare Products Regulatory Agency.
Cyclosporine
Price:
Moderately expensive. Prices and insurance coverage vary widely between jurisdictions and do not include other costs such as physician visits and lab monitoring.
Description:
This medication is taken as pills once or twice daily. An oral solution is also available for children.
Side Effects:
This medication works by suppressing the immune system, so it makes people more prone to infections and in some cases cancers. Other possible side effects include high blood pressure, impaired kidney function, low blood counts and nerve problems.
Availability:
This medication is approved in Europe for the treatment of eczema in patients who are 16 years or older and is also available for use in other countries "off-label".
Other Notes:
Before taking this medication and while on it, you will need to have regular blood pressure checks and blood tests to monitor for side effects. Most recommendations limit use of this medication to one year.
Click here for additional information and patient handouts from the UK National Eczema Society.
Dupilumab
Price:
Very expensive. Prices and insurance coverage vary widely between jurisdictions and do not include other costs such as physician visits.
Description:
This biologic medication is given by injection every two weeks or monthly, depending on weight and age groups.
Side Effects:
A common side effect is conjunctivitis, or irritation of the eyes. Other possible side effects include reactions at the site of injections. In addition, joint pain (arthralgia) and upper respiratory tract infections have been reported.
Availability:
This medication is approved for use in people aged 6 and older with eczema in many countries.
Other Notes:
Insurance coverage for this medication is highly variable from place-to-place and plan-to-plan. In most European countries dupilumab can only be prescribed if patients have already tried conventional immunomodulatory systemic medications, or if other medications cannot be used.
Click here for additional information and patient handouts from the UK National Eczema Society.
Lebrikizumab
Price:
Very expensive. Prices and insurance coverage vary widely between jurisdictions and do not include other costs such as physician visits.
Description:
This biologic medication is given by injection every two weeks. After the first 4 months, it can sometimes be given every 4 weeks.
Side Effects:
A common side effect is conjunctivitis, or irritation of the eyes. Other possible side effects include reactions at the site of injections.
Availability:
This medication is approved for use in people aged 12 and older with eczema in many countries.
Other Notes:
Insurance coverage for this medication is highly variable from place-to-place and plan-to-plan.
Click here for more useful information from the UK's National Institute for Health and Care Excellence
Methotrexate
Price:
Inexpensive. Prices and insurance coverage vary widely between jurisdictions and do not include other costs such as physician visits and lab monitoring.
Description:
This medication is typically taken as pills once per week but can also be given by injection. Oral solution is also available for children. Patients usually take folic acid pills on the days they don't take methotrexate. This helps to counteract nausea, stomach upset and potential anemia.
Side Effects:
Possible side effects include liver abnormalities, low blood counts, lung/breathing problems, hair loss and an upset stomache/nausea. It should not be taken by women considering getting pregnant or during pregnancy as it can lead to pregnancy termination or cause problems for the baby. It should also not be taken by men trying to conceive.
Availability:
This medication is not specifically approved for eczema, but it is available in many countries "off-label".
Other Notes:
Before taking this medication and while on it, you will need to have blood tests to monitor for side effects.
Click here for additional information and patient handouts from the UK National Eczema Society.
Mycophenolate
Price:
Moderately expensive. Prices and insurance coverage vary widely between jurisdictions and do not include other costs such as physician visits and lab monitoring.
Description:
This medication is typically taken as pills twice daily. Oral solution is also available for children.
Side Effects:
This medication works by suppressing the immune system, so it can increase rates of infections and, potentially, cancers. Other possible side effects include liver abnormalities and low blood counts. Women should not take it during pregnancy because it can cause problems for the baby. It can also cause upset stomach/nausea/diarrhea.
Availability:
This medication is not specifically approved for eczema, but it is available in many countries "off-label".
Other Notes:
Before taking this medication and while on it, you will need to have regular blood tests to monitor for side effects.
Click here for additional information and patient handouts from the UK National Eczema Society.
Tralokinumab
Price:
Very expensive. Prices and insurance coverage vary widely between jurisdictions and do not include other costs such as physician visits.
Description:
This medication is given by injection every two weeks.
Side Effects:
A common side effect is conjunctivitis, or irritation sensation of the eyes. In addition, upper respiratory tract infections have been reported.
Availability:
This medication is approved for use in people aged 18 and older with eczema in many countries.
Other Notes:
Insurance coverage for this medication is highly variable from place-to-place and plan-to-plan. In most European countries tralokinumab can only be prescribed if patients have already tried conventional immunomodulatory systemic medications, or if other medications cannot be used.
Click here for additional information and patient handouts from the Medicines & Healthcare Products Regulatory Agency.
Upadacitinib 15mg
Price:
Very expensive. Prices and insurance coverage vary widely between jurisdictions and do not include other costs such as physician visits.
Description:
This is a Janus Kinase Inhibitor medication taken orally (pills) once daily
Side Effects:
Upadacitinib has been associated with an increased risk of upper respiratory tract infections, acne, headache, and various changes in blood tests, nausea and abdominal pain as well as herpes virus infections. Tofacitinib, another Janus Kinase (JAK) inhibitor used to treat arthritis, has been associated with increased serious infection, cancer, clotting and heart disease risk. While these risks have not been demonstrated with JAK inhibitors used to treat eczema, clinicians and patients should be aware of these risks.
Availability:
This medication is approved for use in people aged 12 and older with eczema in many countries.
Other Notes:
Insurance coverage for this medication is highly variable from place-to-place and plan-to-plan. In most European countries upadacitinib can only be prescribed if patients have already tried other systemic medications, or if other medications cannot be used.
Click here for additional information and patient handouts from the Medicines & Healthcare Products Regulatory Agency.
Upadacitinib 30mg
Price:
Very expensive. Prices and insurance coverage vary widely between jurisdictions and do not include other costs such as physician visits.
Description:
This is a Janus Kinase Inhibitor medication taken orally (pills) once daily
Side Effects:
Upadacitinib has been associated with an increased risk of upper respiratory tract infections, acne, headache, and various changes in blood tests, nausea and abdominal pain as well as herpes virus infections. Tofacitinib, another Janus Kinase (JAK) inhibitor used to treat arthritis, has been associated with increased serious infection, cancer, clotting and heart disease risk. While these risks have not been demonstrated with JAK inhibitors used to treat eczema, clinicians and patients should be aware of these risks.
Availability:
This medication is approved for use in people aged 12 and older with eczema in many countries.
Other Notes:
Insurance coverage for this medication is highly variable from place-to-place and plan-to-plan. In most European countries upadacitinib can only be prescribed if patients have already tried other systemic medications, or if other medications cannot be used.
Click here for additional information and patient handouts from the Medicines & Healthcare Products Regulatory Agency.
Priorities
Improvement in Itch
Improvement in Quality of Life
Improvement in Clinical Signs (Rash)
How Certain are we
Certainty refers to how confident we are with the results. Things that affect our confidence include how statistically precise our results are as well as the quality of the trials included in the analysis.
Trial Lengths
Clinical trials for atopic dermatitis have different lengths with some ending after a few weeks and others going up to a year. For our analysis, we divided trials into those 16 weeks or shorter and longer than 16 weeks.
Relative effectiveness
In our NMA, we compare every medication within a network, together. These results reflect how effective each medication is relative to each other and how likely a given medication is to be better than the others. To learn more about how we derive this, visit our research section.