{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T22:53:19Z","timestamp":1780959199493,"version":"3.54.1"},"reference-count":37,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T00:00:00Z","timestamp":1725235200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR201993"],"award-info":[{"award-number":["NIHR201993"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Experimental Allergy"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Eczema is the most burdensome skin condition worldwide and topical anti\u2010inflammatory treatments are commonly used to control symptoms. The relative effectiveness and safety of different topical anti\u2010inflammatory treatments is uncertain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Network meta\u2010analysis performed within a Cochrane systematic review to compare and statistically rank efficacy and safety of topical anti\u2010inflammatory eczema treatments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources<\/jats:title><jats:p>Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase and trial registries to June 2023.<\/jats:p><\/jats:sec><jats:sec><jats:title>Eligibility Criteria for Selected Trials<\/jats:title><jats:p>Included trials were within\u2010participant or between\u2010participant randomised controlled trials. Participants had eczema that was not clinically infected and was not contact dermatitis, seborrheic eczema or hand eczema. Interventions were topical anti\u2010inflammatory treatments but not complementary treatments, antibiotics alone, wet wraps, phototherapy or systemic treatments. Comparators were no treatment\/vehicle or another topical anti\u2010inflammatory.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 291 trials (45,846 participants), mainly in high\u2010income countries. Most were industry\u2010funded with median 3\u2009weeks treatment duration. Risk of bias assessed using the Cochrane Risk of Bias 2.0 tool was high in 89% of trials, mainly due to risk of selective reporting. Network meta\u2010analysis of binary outcomes ranked potent and\/or very potent topical steroids, tacrolimus 0.1% and ruxolitinib 1.5% among the most effective treatments for improving patient\u2010reported symptoms (40 trials, all low confidence) and clinician\u2010reported signs (32 trials, all moderate confidence). For investigator global assessment, the Janus kinas inhibitors ruxolitinib 1.5%, delgocitinib 0.5% or 0.25%, very potent\/potent topical steroids and tacrolimus 0.1% were ranked as most effective (140 trials, all moderate confidence). Continuous outcome data were mixed. Local application site reactions were most common with tacrolimus 0.1% (moderate confidence) and crisaborole 2% (high confidence) and least common with topical steroids (moderate confidence). Skin thinning was not increased with short\u2010term use of any topical steroid potency (low confidence) but skin thinning was reported in 6\/2044 (0.3%) participants treated with longer\u2010term (6\u201360\u2009months) topical steroids.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Potent topical steroids, Janus kinase inhibitors and tacrolimus 0.1% were consistently ranked as among the most effective topical anti\u2010inflammatory treatments for eczema.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cea.14556","type":"journal-article","created":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T07:54:06Z","timestamp":1725263646000},"page":"960-972","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Topical Anti\u2010Inflammatory Treatments for Eczema: A Cochrane Systematic Review and Network Meta\u2010Analysis"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7000-9364","authenticated-orcid":false,"given":"Stephanie J.","family":"Lax","sequence":"first","affiliation":[{"name":"Centre of Evidence Based Dermatology University of Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleanor","family":"Van Vogt","sequence":"additional","affiliation":[{"name":"Imperial Clinical Trials Unit Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bridget","family":"Candy","sequence":"additional","affiliation":[{"name":"Department of Dermatology Royal Free Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lloyd","family":"Steele","sequence":"additional","affiliation":[{"name":"Wellcome Sanger Institute  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Reynolds","sequence":"additional","affiliation":[{"name":"School of Public Health, Physiotherapy and Sports Science, University College Dublin  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth","family":"Stuart","sequence":"additional","affiliation":[{"name":"Primary Care and Population Sciences, Faculty of Medicine University of Southampton  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roses","family":"Parker","sequence":"additional","affiliation":[{"name":"Cochrane MOSS Network, c\/o Cochrane Pain Palliative and Supportive Care Group  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Axon","sequence":"additional","affiliation":[{"name":"Cochrane Methods Support Unit Cochrane  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Roberts","sequence":"additional","affiliation":[{"name":"Nottingham Support Group for Carers of Children With Eczema  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Doyle","sequence":"additional","affiliation":[{"name":"Centre of Evidence Based Dermatology University of Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8269-4496","authenticated-orcid":false,"given":"Derek K.","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Medicine McMaster University  Hamilton Ontario Canada"},{"name":"Department of Health Research Methods, Evidence &amp; 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