Background: Mucopolysaccharide polysulfate (MPS) cream as a moisturizer is widely applied to treat eczema, and a lot of clinical trials have demonstrated its efficacy and safety. However, there is no further research to collect and analyze these studies.Objective: This meta-analysis aimed to assess the efficacy and safety of MPS cream as monotherapy or add-on therapy for non-exudative eczema.Methods: Ten databases were searched to identify the eligible randomized controlled trials (RCTs) from their inception to July 31, 2021. Revman 5.3 software was used for the meta-analysis.Results: A total of eligible 20 studies were included. Among the 20 studies, 2 studies compared MPS cream with other moisturizers, 14 compared MPS cream plus topical corticosteroids (TCS) with TCS alone, and 4 compared with MPS cream plus tacrolimus ointment with tacrolimus ointment alone. The pooled results demonstrated that MPS cream had a higher total efficacy rate [Risk ratio (RR) 1.21, 95% CI: 1.12 to 1.30, P < 0.00001], a lower recurrence rate (RR 0.44, 95% CI: 0.26 to 0.74, P = 0.002) and a lower pruritus score [mean difference (MD) −1.78, 95% CI: −2.16 to −1.40, P < 0.00001] than urea cream or vaseline ointment. Moreover, in comparison with TCS or tacrolimus ointment alone, the combination treatment performed better in terms of total efficacy rate, total symptom score, recurrence rate, and pruritus score. For safety, the skin adverse events were mild, and MPS cream as monotherapy or add-on therapy did not increase the risk of skin adverse events.Conclusions: MPS cream as monotherapy or add-on therapy could provide a good effect for treating non-exudative eczema with mild and tolerable skin adverse events. However, due to the suboptimal quality of the included studies, high-quality and large-sample RCTs are needed in the future for update or validation.Systematic Review Registration: PROSPERO (https://www.crd.york.ac.uk/PROSPERO/), identifier: CRD42021265735.

Context Tripterygium glycosides (TG), a traditional Chinese medicine, has been used to treat chronic urticaria (CU) in China, and the evidence of TG for CU needs to be updated thoroughly. Objective To systematically evaluate the efficacy and safety of TG combined with H1-antihistamine (H1-AH) in adults with CU. Methods Eligible randomized controlled trials were searched in eight databases until May 31, 2022, including CNKI, WanFang, VIP, SinoMed, PubMed, Cochrane Library, Embase, and Web of Science. The search terms included urticaria, Tripterygium , Lei Gong Teng, and Leigongteng. Rev Man 5.3 and Stata 12.0 were used for statistical analysis. Results A total of 27 studies with 2788 patients were included. The pooled results showed that TG plus H1-AH was superior to H1-AH alone in cure rate (RR = 1.37, 95% CI = 1.15 to 1.63, p = 0.0003), total efficacy rate (RR = 1.40, 95% CI = 1.30 to 1.50, p < 0.00001), pruritus (MD = −0.32, 95% CI = −0.54 to −0.11, p = 0.003), wheal number (MD = −0.31, 95% CI = −0.55 to −0.07, p = 0.01), wheal size (MD = −0.32, 95% CI = −0.46 to −0.19, p < 0.00001), and the serum level of immunoglobulin E (SMD = −1.39, 95% CI = −2.42 to −0.36, p = 0.008). Moreover, adverse events between two groups were mild, and their incidences were not significantly different. Conclusions The combination of TG and H1-AH is a promising and safe treatment for adults with refractory CU. Further high-quality studies are needed to confirm the evidence.

To the Editor, The type 2 immune response is mediated by Th2 and ILC2s cells, through the production of type 2 cytokines such as IL-4, IL-13, and IL-5. Multiple cells, including eosinophils, are active by these cytokines. In healthy individuals, eosinophils account for 1%-5% of peripheral blood leukocytes. The type 2 inflammatory diseases include a series of allergic, immune diseases, such as atopic dermatitis, asthma, allergic rhinitis and eosinophilic esophagitis. 1,2 Dupilumab is a fully human monoclonal antibody, which blocks IL-4/13. Clinical studies have shown optimistic efficacy of Dupilumab, while some studies found that Dupilumab could induce an increase in blood eosinophils. 3 Clinicians may be concerned about whether changes in eosinophils may limit the continued use of Dupilumab. 4 In this study, we evaluated the changes in eosinophil counts after Dupilumab treatment through meta-analysis. Data from different studies were merged, and at different weeks, comprehensive results were obtained.We searched five databases up to December 31, 2021, to select eligible publications. For included studies, quality was assessed.For randomized studies, the risk of bias tool was applied. For observational studies, Newcastle-Ottawa Scale was applied. The standardized mean difference (SMD) was used to evaluate the change.According to the between-study heterogeneity, fixed or random effect model was selected. The detail of selection and study quality were in Figure S1.Ten studies were included. Three diseases were included and analyzed through meta-analysis. The detail was in Table 1. At weeks 8, 16, 48, 100, and 148, eosinophil counts showed significant decrease (P < .05), which were SMD = −0.18 (95%CI: −0.31, −0.05); −0.17