Short-term topical
therapies in treating plaque psoriasis: An updated systematic review and
network meta-analysis
Weiwei Wu1,2 ,Nan Gao1,2, Chengcheng
Xiong1,2, Yan Zhang1,2,and Xianfeng
Fang1,2*
1 Department of Dermatology, The First College of Clinical Medical
Sciences, China Three Gorges University, Yichang, China,
2 Department of Dermatology, Yichang Central People’s Hospital, Yichang,
China
*Correspondence: Xianfeng Fang , Department of Dermatology, The First
College of Clinical Medical Sciences, China Three Gorges University,
Yichang, China. Email:fangxianfeng001@163.com
Phone:0717-6487947
Abstract :
Background: Plaque psoriasis
is a relapsing immune-mediated skin disease and it characterised by
redness, thickness and scaling.
Topical
therapies is the cornerstone for treating psoriasis.
Objective: To perform a
network meta-analysis(NMA) of
randomized controlled trials of topical therapies for plaque psoriasis,
especially some new drugs for
psoriasis.Our objective was to establish the effectiveness, tolerability
and safety of topical treatments for people with chronic plaque
psoriasis.
Methods: We systematically searched PubMed, Cochrane Library
and Embase databases to identify randomized controlled trials
of topical therapies in adult
patients with plaque psoriasis.Due to older literature were not able to
included some novel topical therapies,we only searched the article that
published between 01 January 2010 and 20 February 2022 in English. The
primary efficacy assessment criteria were treatment
success(the number of patients who
achieved physician’s global assessment or Investigator’s global
assessment of a score of clear or nearly clear(PGA0/1,IGA0/1)) and the
paitents who reported
adverse
events (AEs) at 4-12 weeks. Secondary criteria were
the propotion of patients with 75
% reductions in Psoriasis Area and Severity Index (PASI 75)
and
the number of patients who
reported drug withdrawal due to adverse events at 4-12 weeks.We combined
with
hierarchical cluster analysis to
consider efficacy,
safety and tolerability.
Results: The review included 24 randomized controlled trials of
topical treatments for plaque psoriasis with 9748 participants. This
network meta-analysis showed that topical treatments were significantly
more effective than placebo at 4-12weeks, in addition to tofacitinib
ointment. hierarchical cluster analyses shows
that topical calcipotriene and
betamethasone
dipropionate(Cal/BD),roflumilast,betamethasone,halobetasol-propionate
and tazarotene(HP/TAZ),
halobetasol were comparable with respect to high short-term efficacy,
safety and
tolerability, especially Cal/BD and
roflumilast.
Limitations: limited direct comparisons and lack of long-term
assessment.
Conclusions: Topical Cal/BD and Roflumilast had greater
efficacy safety and tolerability than other topical drugs in 4-12weeks.
Keywords: plaque psoriasis; topical therapies; meta-analysis