Topical use of mammalian target of rapamycin inhibitors in dermatology: A systematic review with meta-analysis.
Administration, Cutaneous
Angiofibroma
/ complications
Antibiotics, Antineoplastic
/ administration & dosage
Humans
Port-Wine Stain
/ drug therapy
Psoriasis
/ drug therapy
Sirolimus
/ administration & dosage
Skin Neoplasms
/ complications
TOR Serine-Threonine Kinases
/ antagonists & inhibitors
Tuberous Sclerosis
/ complications
dermatology
mTOR inhibitor
rapamycin
sirolimus
systematic review
topical
Journal
Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132
Informations de publication
Date de publication:
Mar 2019
Mar 2019
Historique:
received:
18
09
2018
revised:
23
10
2018
accepted:
30
10
2018
entrez:
13
2
2019
pubmed:
13
2
2019
medline:
26
3
2019
Statut:
ppublish
Résumé
Systemic mammalian target of rapamycin (mTOR) inhibitors are currently used in many dermatologic indications. Their topical use is recent and poorly codified. To provide an overview of the topical use of mTOR inhibitors in dermatologic conditions and evaluate their efficacy and safety. A literature search was performed in January 2017. Reports of all studies investigating the use of topical mTOR inhibitors in any dermatology diseases were included. The exclusion criteria were systemic use and mucosal administration. We included 40 studies with a total of 262 patients. In all, 11 dermatologic conditions were found, the most frequent being angiofibromas linked to tuberous sclerosis complex (157 patients). Topical mTOR inhibitors were significantly more efficient than placebo for angiofibromas (relative risk, 2.52; 95% confidence interval, 1.27-5.00; I High heterogeneity in most studies. This systematic review supports the efficacy of topical sirolimus for angiofibromas linked to tuberous sclerosis complex, with only local side effects reported. Other indications require further research.
Sections du résumé
BACKGROUND
BACKGROUND
Systemic mammalian target of rapamycin (mTOR) inhibitors are currently used in many dermatologic indications. Their topical use is recent and poorly codified.
OBJECTIVE
OBJECTIVE
To provide an overview of the topical use of mTOR inhibitors in dermatologic conditions and evaluate their efficacy and safety.
METHODS
METHODS
A literature search was performed in January 2017. Reports of all studies investigating the use of topical mTOR inhibitors in any dermatology diseases were included. The exclusion criteria were systemic use and mucosal administration.
RESULTS
RESULTS
We included 40 studies with a total of 262 patients. In all, 11 dermatologic conditions were found, the most frequent being angiofibromas linked to tuberous sclerosis complex (157 patients). Topical mTOR inhibitors were significantly more efficient than placebo for angiofibromas (relative risk, 2.52; 95% confidence interval, 1.27-5.00; I
LIMITATIONS
CONCLUSIONS
High heterogeneity in most studies.
CONCLUSION
CONCLUSIONS
This systematic review supports the efficacy of topical sirolimus for angiofibromas linked to tuberous sclerosis complex, with only local side effects reported. Other indications require further research.
Identifiants
pubmed: 30744877
pii: S0190-9622(18)32905-0
doi: 10.1016/j.jaad.2018.10.070
pii:
doi:
Substances chimiques
Antibiotics, Antineoplastic
0
MTOR protein, human
EC 2.7.1.1
TOR Serine-Threonine Kinases
EC 2.7.11.1
Sirolimus
W36ZG6FT64
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
735-742Informations de copyright
Copyright © 2018 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.