Atopic dermatitis (AD) in pediatric patients is characterized by itch, substantially influencing their quality of life and that of their caregivers. This systematic review and meta-analysis sought to assess the antipruritic effects of systemic treatments for chronic inflammatory skin disease in children.

Researchers conducted searches in Web of Science, Cochrane, EMBASE, and PubMed databases, focusing on studies presenting original data on the impact of systemic treatments on pruritus in pediatric AD sufferers (aged <18 years). Meta-analysis encompassed placebo-controlled trials stating a Peak Pruritus Numerical Rating Scale 4 (PP-NRS4) response.

The review encompassed 30 studies, with a predominant focus on Dupilumab. Notably, substantial reductions (50% or more) in pruritus were witnessed with Dupilumab (six months-seventeen years), Cyclosporin A (two-sixteen years), Abrocitinib, and Upadacitinib (both twelve and seventeen years). Nemolizumab (12-17 years) displayed promise in pruritus alleviation in pediatric patients, albeit with limited data.

The meta-analysis, incorporating five randomized controlled trials, revealed that Upadacitinib, Abrocitinib, and Dupilumab exhibited a considerably higher likelihood of attaining a PP-NRS4 response when compared to placebo.

Cyclosporin A, Dupilumab, Abrocitinib, and Upadacitinib illustrated effectiveness in tackling pruritus, thereby boosting the quality of life for AD-affected children. With the escalating availability of systemic therapies for AD, it is crucial to incorporate patient-oriented treatment goals, like pruritus mitigation, in therapeutic decision-making.