Quality assessmentNo of patientsEffectQuality
No of studiesDesignRisk of biasInconsistencyIndirectnessImprecisionOther considerationsClobetasol propionatePlaceboRelative (95% CI)Absolute
Duration of remission (N still in remission) - 1 month (follow-up 1 month)
1
Poulin 2010
randomised trialsvery seriousano serious inconsistencyseriousbno serious imprecisionnone48/67 (71.6%)30/69 (43.5%)RR 1.65 (1.21 to 2.24)283 more per 1000 (from 91 more to 539 more)⊕○○○
VERY LOW
Duration of remission (N still in remission) - 2 months (follow-up 2 months)
1
Poulin 2010
randomised trialsvery seriousano serious inconsistencyseriousbno serious imprecisionnone41/67 (61.2%)20/69 (29%)RR 2.11 (1.39 to 3.2)322 more per 1000 (from 113 more to 638 more)⊕○○○
VERY LOW
Duration of remission (N still in remission) - 3 months (follow-up 3 months)
1
Poulin 2010
randomised trialsvery seriousano serious inconsistencyseriousbno serious imprecisionnone39/67 (58.2%)13/69 (18.8%)RR 3.09 (1.82 to 5.25)394 more per 1000 (from 154 more to 801 more)⊕○○○
VERY LOW
Duration of remission (N still in remission) - 4 months (follow-up 4 months)
1
Poulin 2010
randomised trialsvery seriousano serious inconsistencyseriousbno serious imprecisionnone34/67 (50.7%)11/69 (15.9%)RR 3.18 (1.76 to 5.75)348 more per 1000 (from 121 more to 757 more)⊕○○○
VERY LOW
Duration of remission (N still in remission) - 5 months (follow-up 5 months)
1
Poulin 2010
randomised trialsvery seriousano serious inconsistencyseriousbno serious imprecisionnone30/67 (44.8%)10/69 (14.5%)RR 3.09 (1.64 to 5.81)303 more per 1000 (from 93 more to 697 more)⊕○○○
VERY LOW
Duration of remission (N still in remission) - 6 months (follow-up 6 months)
1
Poulin 2010
randomised trialsvery seriousano serious inconsistencyseriousbno serious imprecisionnone27/67 (40.3%)8/69 (11.6%)RR 3.48 (1.7 to 7.1)288 more per 1000 (from 81 more to 707 more)⊕○○○
VERY LOW
Median time to relapse (follow-up 6 months)
1
Poulin 2010
randomised trialsvery seriousano serious inconsistencyseriousbseriouscnone6769-Placebo: 30.5 days

Clobetasol propionate: 141 days
⊕○○○
VERY LOW
Skin atrophy (follow-up 6 months)
1
Poulin 2010
randomised trialsvery seriousano serious inconsistencyno serious indirectnessvery seriousdnone1/67 (1.5%)0/69 (0%)RR 3.09 (0.13 to 74.5)-⊕○○○
VERY LOW
Withdrawals due to adverse events (follow-up 6 months)
1
Poulin 2010
randomised trialsvery seriousano serious inconsistencyno serious indirectnessvery seriousdnone2/60 (3.3%)0/52 (0%)RR 4.34 (0.21 to 88.48)-⊕○○○
VERY LOW
a

Unclear allocation concealment and blinding and higher drop-out rate in placebo group; patients in vehicle group received active treatment if relapse occurred during maintenance phase

b

Incorrect/less stringent definition of remission (at least mild on PGA)

c

No range given

d

Confidence interval crosses the boundary for clinical significance in favour of both treatments, as well as line of no effect Relapse data for this study is based on ITT analysis (worst case population; those who discontinued before relapse were considered as having relapse at the next visit)

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.

Apart from any fair dealing for the purposes of research or private study, criticism or review, as permitted under the Copyright, Designs and Patents Act, 1988, no part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.

The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore for general use.

The rights of National Clinical Guideline Centre to be identified as Author of this work have been asserted by them in accordance with the Copyright, Designs and Patents Act, 1988.

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.