Efficient topical treatments of cutaneous lupus erythematosus: a systematic review and network -meta-analysis.

Autor:	Fukasawa T; Department of Dermatology, Systemic Sclerosis Centre, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.; Department of Clinical Cannabinoid Research, The University of Tokyo Graduate School of Medicine, Tokyo, Japan., Yoshizaki-Ogawa A; Department of Dermatology, Systemic Sclerosis Centre, The University of Tokyo Graduate School of Medicine, Tokyo, Japan., Enomoto A; Laboratory of Molecular Radiology, Center for Disease Biology and Integrative Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan., Miyagawa K; Laboratory of Molecular Radiology, Center for Disease Biology and Integrative Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan., Sato S; Department of Dermatology, Systemic Sclerosis Centre, The University of Tokyo Graduate School of Medicine, Tokyo, Japan., Yoshizaki A; Department of Dermatology, Systemic Sclerosis Centre, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.; Department of Clinical Cannabinoid Research, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.
Jazyk:	angličtina
Zdroj:	Clinical and experimental dermatology [Clin Exp Dermatol] 2024 Dec 23; Vol. 50 (1), pp. 21-28.
DOI:	10.1093/ced/llae236
Abstrakt:	Although topical agents have been used to treat cutaneous lupus erythematosus (CLE), there was previously no high-quality evidence of which agents were most effective and which clinical scores were most suitable. On 22 December 2023, a search was conducted across five databases to identify randomized controlled trials (RCTs) for CLE. Two authors independently screened the titles and abstracts of articles based on predetermined criteria. Selected articles were then assessed for inclusion in a blinded manner, with any disagreements resolved through consensus. Data were abstracted in duplicate, and a random-effects model was utilized for network meta-analysis. The certainty of the evidence was evaluated according to the PRISMA guidelines, using the GRADE approach. The analysis was finalized in January 2024, with the primary outcome focused on the change in Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) from baseline. Seven RCTs involving 231 participants were analysed. The network meta-analysis revealed that nicotinamide 4% demonstrated the highest probability of achieving the intended outcomes, with a mean difference (MD) of 3.10 and a 95% confidence interval (CI) of 1.99-4.21. Additionally, clobetasol 0.05%, nicotinamide 2% and tacrolimus 0.1% also exhibited statistically significant differences, with MDs of 2.30 (95% CI of 0.73-3.88), 2.30 (95% CI 0.97-3.63) and 1.30 (95% CI 0.03-2.57), respectively. This NMA demonstrates with a high level of evidence that nicotinamide 4%, clobetasol 0.05%, nicotinamide 2% and tacrolimus 0.1% are statistically significant topical agents for CLE. CLASI may be an appropriate outcome to evaluate drug efficacy in CLE. Competing Interests: Conflicts of interest TF and AY belong to the Social Cooperation Program, Department of Clinical Cannabinoid Research, supported by the Japan Cosmetic Association and Japan Federation of Medium & Small Enterprise Organizations. The other authors have declared that no conflicts of interest exist. (© The Author(s) 2024. Published by Oxford University Press on behalf of British Association of Dermatologists. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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