Combination treatments for psoriasis: A systematic review and meta-analysis

Elizabeth E. Bailey, Elisabeth H. Ference, Ali Alikhan, Meghan T. Hession, April W. Armstrong

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Objective: To summarize the current state of evidence for combination topical and systemic therapies for mild to severe psoriasis. Data Sources: We performed a systematic search for all entries in PubMed, CINAHL, Cochrane Review, and EMBASE related to combination treatments for psoriasis through July 2010. Study Selection: We included randomized controlled trials that reported proportion of disease clearance or mean change in clinical severity score (or provided these data through communication with study authors) for efficacy of a combination treatment for psoriasis compared with 1 or more corresponding monotherapies. Data Extraction: Study data were extracted by 3 independent investigators, with disagreement resolved by consensus. The proportion of patients who achieved clearance, definition of clearance, means and standard deviations for baseline disease symptom score and final disease symptom score, and major design characteristics were extracted for each study. Data Synthesis: Combination treatments consisting of vitamin D derivative and corticosteroid, vitamin D derivative and UV-B, vitamin A derivative and psoralen-UV-A, vitamin A derivative and corticosteroid, vitamin A derivative and UV-B, corticosteroid and hydrocolloid occlusion dressings, UV-B and alefacept, and vitamins A and D derivatives were more effective than 1 or more monotherapies using the likelihood of clearance as the outcome. Blinding status and potency of the corticosteroid treatment used were significant sources of heterogeneity between studies. Conclusions: The results demonstrate the need for additional long-term trials with standardized outcome measures to evaluate the efficacy and adverse effects of combination therapies for psoriasis and highlight the possible effects of trial design characteristics on results.

Original languageEnglish (US)
Pages (from-to)511-522
Number of pages12
JournalArchives of Dermatology
Volume148
Issue number4
DOIs
StatePublished - Apr 2012

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Psoriasis
Meta-Analysis
Vitamin A
Adrenal Cortex Hormones
Vitamin D
Vitamin B Complex
Hydrocolloid Bandages
Therapeutics
Ficusin
Information Storage and Retrieval
PubMed
Consensus
Randomized Controlled Trials
Communication
Research Personnel
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Dermatology

Cite this

Bailey, E. E., Ference, E. H., Alikhan, A., Hession, M. T., & Armstrong, A. W. (2012). Combination treatments for psoriasis: A systematic review and meta-analysis. Archives of Dermatology, 148(4), 511-522. https://doi.org/10.1001/archdermatol.2011.1916

Combination treatments for psoriasis : A systematic review and meta-analysis. / Bailey, Elizabeth E.; Ference, Elisabeth H.; Alikhan, Ali; Hession, Meghan T.; Armstrong, April W.

In: Archives of Dermatology, Vol. 148, No. 4, 04.2012, p. 511-522.

Research output: Contribution to journalArticle

Bailey, EE, Ference, EH, Alikhan, A, Hession, MT & Armstrong, AW 2012, 'Combination treatments for psoriasis: A systematic review and meta-analysis', Archives of Dermatology, vol. 148, no. 4, pp. 511-522. https://doi.org/10.1001/archdermatol.2011.1916
Bailey, Elizabeth E. ; Ference, Elisabeth H. ; Alikhan, Ali ; Hession, Meghan T. ; Armstrong, April W. / Combination treatments for psoriasis : A systematic review and meta-analysis. In: Archives of Dermatology. 2012 ; Vol. 148, No. 4. pp. 511-522.
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