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