Quality assessmentNo of patientsEffectQuality
No of studiesDesignRisk of biasInconsistencyIndirectnessImprecisionOther considerationsVitamin D or vitamin D analogue
Time-to-remission (marked improvement or clearance (follow-up 1–8 weeks)
1
Highton 1995
observational studiesano serious risk of biasbno serious inconsistencyno serious indirectnessno serious imprecisionnoneCalcipotriol BD
124
Patients achieving marked improvement or clearance⊕⊕○○
LOW
Week 19.6%
Week 227.8%
Week 454.2%
Week 665.1%
Week 8/EOT69.8%
Time-to-remission (clear/nearly clear; follow-up 4–8 weeks)
1
Fleming2010A
observational studiesano serious risk of biasbno serious inconsistencyno serious indirectnessno serious imprecisionnoneCalcipotriol OD
79
Clear/nearly clear (investigator’s static assessment)⊕⊕○○
LOW
Week 426 (16.0%)
Week 844 (27.2%)
Time-to-remission (clear/nearly clear; follow-up 4–8 weeks)
1
Langley 2011A
observational studiesano serious risk of biasbno serious inconsistencyno serious indirectnessno serious imprecisionnoneTacalcitol OD
184
Clear/nearly clear (investigator’s static assessment)⊕⊕○○
LOW
Week 412 (6.5%)
Week 833 (17.9%)
Clear/nearly clear (patient’s static assessment)
Week 421/175 (12.0%)
Week 835/163 (21.5%)
Time-to-maximum response (change in PASI; follow-up 2–6 weeks)
1
Cunliffe 1992
observational studiesano serious risk of biasbno serious inconsistencyno serious indirectnessno serious imprecisionnoneCalcipotriol BD
201
Mean (SD) change in PASI from baseline (mean at baseline = 8.67)⊕⊕○○
LOW
Week 23.19 (3.61)
Week 44.37 (4.70)
Week 65.5 (9.54)
Time-to-maximum response (change in PASI; follow-up 2–4 weeks)
1
Dubertret 1992
observational studiesano serious risk of biasbno serious inconsistencyno serious indirectnessno serious imprecisionnoneCalcipotriol BD
65
Mean (SD) PASI during initial 4-week randomised treatment phase⊕⊕○○
LOW
Mean baseline PASI (n=65)14.2 ± 7.5
After 2 weeks (n=62)
Mean PASI8.6 ± 7.5
% change from baseline41.2 ± 25.7
After 4 weeks (n=60)
Mean PASI6.3 ± 6.5
% change from baseline58.6 ± 31.7
Time-to-maximum response (change in PASI; follow-up 2–12 weeks)
1
Saraceno 2007
observational studiesano serious risk of biascno serious inconsistencyno serious indirectnessno serious imprecisionnoneCalcipotriol BD
75
Mean PASI (SD)⊕⊕○○
LOW
Baseline9.11 (4.09)
2 weeks5.47 (3.47)
4 weeks4.07 (3.33)
8 weeks3.45 (3.77)
12 weeks3.04 (3.76)
Time-to-maximum response (% change in PASI; follow-up 2–4 weeks)
1
Ortonne 2004
observational studiesano serious risk of biasdno serious inconsistencyno serious indirectnessno serious imprecisionnoneTacalcitol OD
252
Mean % reduction in PASI score from baseline⊕⊕○○
LOW
2 weeks24.5%
4 weeks33.3%
Time-to-maximum response (% change in PASI; follow-up 4–8 weeks)
1
Langley 2011A
observational studiesano serious risk of biasbno serious inconsistencyno serious indirectnessno serious imprecisionnoneTacalcitol OD
184
% change in PASI⊕⊕○○
LOW
week 4−37.3
week 8−41.9
Time-to-maximum response (% change in mPASI [0.64.8]; follow-up 4–12 weeks)
1
Alora-Palli 2010
observational studiesano serious risk of biaseno serious inconsistencyno serious indirectnessno serious imprecisionnoneCalcipotriol BD
28
% change in PASI from baseline⊕⊕○○
LOW
Baseline7.07
4 weeks5.09 (−30.2%)
8 weeks4.71 (−34.2%)
12 weeks4.66 (−36.5%)
Time-to-maximum response (% change in PASI; follow-up 2–6 weeks)
1
Tham 1994
observational studiesano serious risk of biasbno serious inconsistencyno serious indirectnessno serious imprecisionnoneCalcipotriol BD
27
Mean PASI (italics) and % change in PASI score from baseline⊕⊕○○
LOW
Baseline6.6±4.9
2 weeks4.1±3.4
−36.9±25.0%
4 weeks2.8±2.2
−57.5±19.4%
6 weeks2.0±2.1
−69.8±20.4%
a

Although the data are taken from randomised trials the benefit of control data is not being utilised as considerations are being made based on single interventions without reference to the comparator arm

b

Unclear allocation concealment may have biased patient selection for this intervention

c

Unclear allocation concealment may have biased patient selection for this intervention and there was a high rate of dropout (38.7%)

d

Unclear allocation concealment may have biased patient selection for this intervention and there was a high rate of dropout (20.2%)

e

Unclear allocation concealment may have biased patient selection for this intervention and there was a high rate of dropout (26.7%)

From: 8, Topical therapy

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Psoriasis: Assessment and Management of Psoriasis.
NICE Clinical Guidelines, No. 153.
National Clinical Guideline Centre (UK).
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