Next-Gen Biotherapeutics: A Systematic Review and Network Meta-Analysis
on Postbiotics as Treatment For Pediatric Atopic Dermatitis
Abstract
Background: Due to the recency of the postbiotic field, there
are no head-to-head postbiotic studies investigating its biotherapeutic
potential for atopic dermatitis (AD). No network meta-analysis (NMA) has
yet been conducted to synthesize relevant studies to compare postbiotic
interventions for AD. Objective: To assess the comparative
efficacy and safety of postbiotic strains for treating pediatric AD.
Methodology: This is an NMA of randomized controlled studies
that evaluate postbiotics in treating pediatric AD. Systematic search of
databases and registers from inception to November 30, 2022. Three
authors independently performed the search, screening, appraisal using
the Cochrane risk of bias tool version 2 and data extraction. Data
analysis was done using STATA14 software. Results: There were 9
studies that evaluated 8 postbiotic preparations. Lactobacillus
rhamnosus IDCC 3201 (LR) ranked highest in the efficacy outcome.
Compared to placebo, LR may be effective in reducing symptoms of atopic
dermatitis both in the main analysis (SMD -0.53, 95%CI -1.02 to -0.04)
and sensitivity analysis involving studies that used SCORAD (MD -5.52,
95% CI -10.46 to -0.58), based on low-certainty evidence. Based on
moderate-certainty evidence, LR probably does not increase the risk of
adverse events (RR 0.97, 95% CI 0.79 to 1.21). Although
Lactobacillus paracasei GM080 (LP2) ranked highest in the safety
outcome, it may not reduce AD symptoms compared to placebo (SMD -0.03,
95% CI -0.37 to 0.32) based on low-certainty evidence.
Conclusion: LR showed significant benefits for children with
AD, based on low-certainty evidence. Further investigation on LR is
recommended.