Condition

Eczema

Atopic dermatitis causing itchy, inflamed skin

204.1M
People Affected
60
Active Trials
10.2M
New Cases/Year
500
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Upadacitinib
92% Effectiveness• 90% Confidence• 45% Safety• 36 trials• 5.5K participants
HIGH EvidencePoor ValueDose: 15-30 mg orally once daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
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45
DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

lifetime

Response Rate

68%

Remission Rate

30%

Number Needed to Treat (NNT)

3

Common Side Effects:

Upper respiratory tract infections: 15%
Acne: 8%
Headache: 7%
Herpes zoster: 3%
Elevated creatine phosphokinase: 6%
Serious infections (including pneumonia): 1%
Major adverse cardiovascular events (MACE): 0.5%
Venous thromboembolism (VTE): 0.5%
Malignancy: 0.3%

Annual Cost of Care

Drug Cost

$42,000

Monitoring

$700

Side Effects

$200

Total Annual

$42,900

Cost-Effectiveness

POOR

QALYs Gained

0.4

ICER

$250,000/QALY

Cost per Remission

$143,000

Cost per Responder

$63,088

Treatment Outcomes
Primary Outcomes
Eczema Area and Severity Index (EASI) Score25 points (0-72 scale)
-80% (-20 points)
Investigator's Global Assessment (IGA) Score3.5 points (0-4 scale)
-85.7% (-3.0 points)
Peak Pruritus Numerical Rating Scale (NRS)7.5 points (0-10 scale)
-66.7% (-5.0 points)
Secondary Benefits
Dermatology Life Quality Index (DLQI) Score18 points (0-30 scale)
-77.8% (-14 points)
PROMIS Sleep Disturbance T-score60 points (higher indicates more disturbance)
-13.3% (-8 points)
SCORAD (Scoring Atopic Dermatitis) Index50 points (0-103 scale)
-70% (-35 points)
Common Side Effects
Upper respiratory tract infections
+15%
Acne
+8%
Headache
+7%

Clinical Trial Phases:

Phase 3Phase 4
2
Dupilumab
90% Effectiveness• 95% Confidence• 60% Safety• 108 trials• 10K participants
HIGH EvidenceModerate ValueDose: 600 mg initial, then 300 mg SC every two weeks
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
60
DangerousModerateSafe

Time to Effect

2-4 weeks

Duration

lifetime

Response Rate

65%

Remission Rate

25%

Number Needed to Treat (NNT)

3

Common Side Effects:

Injection site reactions: 15%
Conjunctivitis: 10%
Oral herpes: 3%
Eosinophilia: 3%

Annual Cost of Care

Drug Cost

$39,000

Monitoring

$400

Side Effects

$100

Total Annual

$39,500

Cost-Effectiveness

MODERATE

QALYs Gained

0.4

ICER

$135,000/QALY

Cost per Remission

$158,000

Cost per Responder

$60,769

Treatment Outcomes
Primary Outcomes
Eczema Area and Severity Index (EASI) score25/72
-75% (-18.75 points)
Investigator's Global Assessment (IGA) score3.5/5
-57.1% (-2.0 points)
Pruritus Numerical Rating Scale (NRS) score7.0/10
-50% (-3.5 points)
Secondary Benefits
Dermatology Life Quality Index (DLQI) score15/30
-65% (-9.75 points)
Patient-Oriented Eczema Measure (POEM) score20/28
-60% (-12.0 points)
Sleep Disturbance Numerical Rating Scale (NRS) score6.0/10
-55% (-3.3 points)
Common Side Effects
Injection site reactions
+15%
Conjunctivitis
+10%
Oral herpes
+3%

Clinical Trial Phases:

Phase 3Phase 4
3
Cyclosporine
88% Effectiveness• 90% Confidence• 30% Safety• 29 trials• 20K participants
HIGH EvidenceGood ValueDose: 2.5-5 mg/kg/day orally
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
30
DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

3-12 months

Response Rate

75%

Remission Rate

50%

Number Needed to Treat (NNT)

3

Common Side Effects:

Nephrotoxicity: 30%
Hypertension: 15%
Headache: 15%
Paresthesia: 12%
Hypertrichosis: 8%
Gingival hyperplasia: 7%
Increased risk of infection: 8%

Annual Cost of Care

Drug Cost

$2,000

Monitoring

$1,500

Side Effects

$300

Total Annual

$3,800

Cost-Effectiveness

GOOD

QALYs Gained

0.2

ICER

$80,000/QALY

Cost per Remission

$7,600

Cost per Responder

$5,067

Treatment Outcomes
Primary Outcomes
Eczema Area and Severity Index (EASI)20/72
-75% (-15 points)
Scoring Atopic Dermatitis (SCORAD)45/103
-60% (-27 points)
Pruritus Numerical Rating Scale (NRS)7/10
-57.1% (-4 points)
Investigator's Global Assessment (IGA)3.5/5
-57.1% (-2 points)
Secondary Benefits
Dermatology Life Quality Index (DLQI)18/30
-66.7% (-12 points)
Sleep Disturbance Numerical Rating Scale (NRS)6/10
-50% (-3 points)
Total Body Surface Area (BSA) Affected25%
-80% (-20 percentage points)
Common Side Effects
Nephrotoxicity
+30%
Hypertension
+15%
Headache
+15%

Clinical Trial Phases:

Phase 4
4
Topical Corticosteroids (e.g., Clobetasol Propionate 0.05%)
85% Effectiveness• 95% Confidence• 48% Safety• 1000 trials• 250K participants
HIGH EvidenceExcellent ValueDose: Apply thinly 1-2 times daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
48
DangerousModerateSafe

Time to Effect

days to 1-2 weeks

Duration

short-term for flares, intermittent for maintenance

Response Rate

80%

Remission Rate

50%

Number Needed to Treat (NNT)

4

Common Side Effects:

Skin atrophy: 15%
Striae: 10%
Telangiectasias: 7%
Perioral dermatitis: 3%
Acne: 3%

Annual Cost of Care

Drug Cost

$100

Monitoring

$150

Side Effects

$50

Total Annual

$300

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.2

Cost per Remission

$600

Cost per Responder

$375

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+85%
Response Rate
+80%
Remission Rate
+50%
Common Side Effects
Skin atrophy
+15%
Striae
+10%
Telangiectasias
+7%

Clinical Trial Phases:

Phase 4
5
Topical Calcineurin Inhibitors (e.g., Tacrolimus Ointment)
80% Effectiveness• 90% Confidence• 38% Safety• 300 trials• 50K participants
HIGH EvidenceGood ValueDose: Apply thinly 2 times daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
38
DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

long-term intermittent use

Response Rate

70%

Remission Rate

40%

Number Needed to Treat (NNT)

4

Common Side Effects:

Application site burning: 35%
Pruritus: 20%
Erythema: 10%
Skin infection: 7%

Annual Cost of Care

Drug Cost

$350

Monitoring

$150

Side Effects

$50

Total Annual

$550

Cost-Effectiveness

GOOD

QALYs Gained

0.2

Cost per Remission

$1,375

Cost per Responder

$786

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+80%
Response Rate
+70%
Remission Rate
+40%
Common Side Effects
Application site burning
+35%
Pruritus
+20%
Erythema
+10%

Clinical Trial Phases:

Phase 4
6
Narrowband UVB Phototherapy
75% Effectiveness• 90% Confidence• 70% Safety• 7 trials• 30K participants
MODERATE EvidenceGood ValueDose: Individualized, gradually increasing doses (J/cm2)
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
70
DangerousModerateSafe

Time to Effect

2-4 weeks

Duration

induction phase (6-12 weeks), then maintenance

Response Rate

60%

Remission Rate

30%

Number Needed to Treat (NNT)

4

Common Side Effects:

Erythema (sunburn-like reaction): 15%
Dry skin: 7%
Pruritus: 7%
Hyperpigmentation: 7%

Annual Cost of Care

Drug Cost

$0

Monitoring

$2,000

Side Effects

$50

Total Annual

$2,050

Cost-Effectiveness

GOOD

QALYs Gained

0.15

ICER

$75,000/QALY

Cost per Remission

$6,833

Cost per Responder

$3,417

Treatment Outcomes
Primary Outcomes
Eczema Area and Severity Index (EASI)18/72
-60% (-10.8 points)
Scoring Atopic Dermatitis (SCORAD)45/103
-55% (-24.75 points)
Investigator's Global Assessment (IGA)3/5 (Moderate)
-33.33% (-1 point)
Pruritus Numeric Rating Scale (NRS)7/10
-50% (-3.5 points)
Secondary Benefits
Dermatology Life Quality Index (DLQI)15/30
-40% (-6 points)
Sleep Disturbance NRS6/10
-30% (-1.8 points)
Topical Corticosteroid Application Frequency5 applications/week
-50% (-2.5 applications/week)
Common Side Effects
Erythema (sunburn-like reaction)
+15%
Dry skin
+7%
Pruritus
+7%

Clinical Trial Phases:

Phase 4