Topical and IL therapies for hidradenitis suppurativa: A systematic literature review.
Hidradenitis suppurativa
IL
Intralesional
Systematic literature review
Topical
Journal
Actas dermo-sifiliograficas
ISSN: 1578-2190
Titre abrégé: Actas Dermosifiliogr
Pays: Spain
ID NLM: 0373062
Informations de publication
Date de publication:
28 Dec 2023
28 Dec 2023
Historique:
received:
12
09
2023
revised:
29
10
2023
accepted:
04
12
2023
medline:
2
1
2024
pubmed:
2
1
2024
entrez:
30
12
2023
Statut:
aheadofprint
Résumé
Topical and intralesional (IL) treatments may be considered the first-line therapy in patients with hidradenitis suppurativa (HS); however, the evidence supporting their use is limited. The aim of our review is to evaluate the efficacy and safety profile of topical and IL treatments in patients with HS. We designed a systematic review of the current medical literature available following the PICO(T) method. And including all types of studies (study type [T]) of individuals with HS of any sex, age, and ethnicity (Population [P]) who received any topical or IL treatment for HS (Intervention [I]) compared to placebo, other treatments, or no treatment at all (Comparator [C]), and reported efficacy and/or safety outcomes (Outcomes [O]). Two outcomes were defined: quality of life and the no. of patients with, at least, 1 adverse event. The search was conducted in the Cochrane Library, MEDLINE, and EMBASE databases; study selection was performed based on predefined criteria. The risk of bias was determined in each study. We obtained a total of 11363 references, 31 of which met the inclusion criteria. These studies included 1143 patients with HS, 62% of whom were women. A total of 10, 8, 6, 2, and 5 studies, respectively, evaluated the use of photodynamic therapy (PDT), glucocorticoids, resorcinol, topical antibiotics, and other interventions. Most articles were case series (n = 25), with only 5 randomized clinical trials (RCTs) and 1 cohort study. RCTs showed improvement in disease activity with topical clindamycin and botulinum toxin (BTX) vs placebo, and PDT with methylene blue (MB) niosomal vs free MB; however, intralesional triamcinolone acetonide was not superior to placebo. The risk of bias was low in 3 RCTs and high in 2 RCTs. The quality of evidence supporting the use of topical, or IL treatments is low. However, it supports the use of topical clindamycin, PDT, and BTX. Well-designed RCTs with standardized outcomes and homogeneous populations of patients and lesions are needed to support decision-making in the routine clinical practice.
Sections du résumé
BACKGROUND AND OBJECTIVE
OBJECTIVE
Topical and intralesional (IL) treatments may be considered the first-line therapy in patients with hidradenitis suppurativa (HS); however, the evidence supporting their use is limited. The aim of our review is to evaluate the efficacy and safety profile of topical and IL treatments in patients with HS.
MATERIALS AND METHODS
METHODS
We designed a systematic review of the current medical literature available following the PICO(T) method. And including all types of studies (study type [T]) of individuals with HS of any sex, age, and ethnicity (Population [P]) who received any topical or IL treatment for HS (Intervention [I]) compared to placebo, other treatments, or no treatment at all (Comparator [C]), and reported efficacy and/or safety outcomes (Outcomes [O]). Two outcomes were defined: quality of life and the no. of patients with, at least, 1 adverse event. The search was conducted in the Cochrane Library, MEDLINE, and EMBASE databases; study selection was performed based on predefined criteria. The risk of bias was determined in each study.
RESULTS
RESULTS
We obtained a total of 11363 references, 31 of which met the inclusion criteria. These studies included 1143 patients with HS, 62% of whom were women. A total of 10, 8, 6, 2, and 5 studies, respectively, evaluated the use of photodynamic therapy (PDT), glucocorticoids, resorcinol, topical antibiotics, and other interventions. Most articles were case series (n = 25), with only 5 randomized clinical trials (RCTs) and 1 cohort study. RCTs showed improvement in disease activity with topical clindamycin and botulinum toxin (BTX) vs placebo, and PDT with methylene blue (MB) niosomal vs free MB; however, intralesional triamcinolone acetonide was not superior to placebo. The risk of bias was low in 3 RCTs and high in 2 RCTs.
CONCLUSION
CONCLUSIONS
The quality of evidence supporting the use of topical, or IL treatments is low. However, it supports the use of topical clindamycin, PDT, and BTX. Well-designed RCTs with standardized outcomes and homogeneous populations of patients and lesions are needed to support decision-making in the routine clinical practice.
Identifiants
pubmed: 38159839
pii: S0001-7310(23)01006-2
doi: 10.1016/j.ad.2023.12.001
pii:
doi:
Types de publication
Journal Article
Langues
eng
spa
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023. Publicado por Elsevier España, S.L.U.