Quality assessmentNo of patientsEffectQuality
No of studiesDesignRisk of biasInconsistencyIndirectnessImprecisionOther considerationsCombination
Time-to-clear/nearly clear (investigator’s assessment; follow-up 4–8 weeks)
1
Langley 2011A
observational studiesano serious risk of biasbno serious inconsistencyno serious indirectnessno serious imprecisionnone183Clear/nearly clear (IGA)⊕⊕○○
LOW
Week 434 (18.6%)
Week 873 (39.9%)
Time-to-clear/nearly clear (investigator’s assessment; follow-up 4–8 weeks)
1
Fleming 2010A
observational studiesano serious risk of biasbno serious inconsistencyno serious indirectnessno serious imprecisionnone162Clear/nearly clear (IGA)⊕⊕○○
LOW
Week 426 (16.0%)
Week 844 (27.2%)
Time-to-clear/nearly clear (patient’s assessment; follow-up 4–8 weeks)
1
Langley 2011A
observational studiesano serious risk of biasbno serious inconsistencyno serious indirectnessno serious imprecisionnone183Clear/nearly clear (patient rating)⊕⊕○○
LOW
Week 452/175 (29.7%)
Week 869/171 (40.4%)
Time-to-maximum effect (% change in PASI; follow-up 4–8 weeks)
1
Langley 2011A
observational studiesano serious risk of biasbno serious inconsistencyno serious indirectnessno serious imprecisionnone183% change in PASI⊕⊕○○
LOW
Week 4−53.1
Week 8−57.0
Time-to-maximum effect (% change in PASI; follow-up 2–4 weeks)
1
Ortonne 2004
observational studiesano serious risk of biasbno serious inconsistencyno serious indirectnessno serious imprecisionnone249Mean % reduction in PASI score from baseline⊕⊕○○
LOW
2 weeks50.5%
4 weeks65.0%
Time-to-maximum effect (change in PASI; follow-up 2–4 weeks)
1
Saraceno 2007
observational studiesano serious risk of biascno serious inconsistencyno serious indirectnessno serious imprecisionnone75Mean PASI (SD)⊕⊕○○
LOW
Baseline9.49 (5.39)
2 weeks3.81 (3.27)
4 weeks2.50 (2.50)
Mean time to maximum response (IAGI) (follow-up 52 weeks)
1
Kragballe 2006
observational studiesano serious risk of biasdno serious inconsistencyno serious indirectnessvery seriousenone212Graph of % satisfactory responses by investigator assessment shows that maximum response is achieved by 12 weeks⊕○○○
VERY LOW
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 (33.3%)

d

Unclear allocation concealment may have biased patient selection for this intervention and there was a high rate of dropout (30.2%)

e

Interpreted from graphical representation

From: 8, Topical therapy

Cover of Psoriasis
Psoriasis: Assessment and Management of Psoriasis.
NICE Clinical Guidelines, No. 153.
National Clinical Guideline Centre (UK).
Copyright © National Clinical Guideline Centre - October 2012.

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