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Date of download: 6/24/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Combination Treatments for Psoriasis: A Systematic.

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Presentation on theme: "Date of download: 6/24/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Combination Treatments for Psoriasis: A Systematic."— Presentation transcript:

1 Date of download: 6/24/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Combination Treatments for Psoriasis: A Systematic Review and Meta-analysis Arch Dermatol. 2012;148(4):511-522. doi:10.1001/archdermatol.2011.1916 Figure 1. Meta-analysis flowchart. One hundred randomized controlled trials (RCTs) met the inclusion criteria for review and possible inclusion in the meta-analysis. Fifty RCTs were included in the meta-analysis for clearance efficacy, and 10 RCTs were included for disease severity score analysis. *Numbers in italics denote studies that were not included in the analysis because only 1 study with sufficient data was available for the subgroup. Figure Legend:

2 Date of download: 6/24/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Combination Treatments for Psoriasis: A Systematic Review and Meta-analysis Arch Dermatol. 2012;148(4):511-522. doi:10.1001/archdermatol.2011.1916 Figure 2. Vitamin D derivative combination therapies and disease clearance efficacy (risk difference [RD]). Combined vitamin D derivative–corticosteroid treatment increased the likelihood of disease clearance compared with vitamin D derivative and corticosteroid monotherapies. Combined vitamin D derivative–UV-B treatment increased the likelihood of disease clearance compared with vitamin D derivative monotherapy but not compared with UV-B monotherapy. Weights are derived from random- effects analysis. Percentages might not total 100 because of rounding. Solid diamonds represent risk estimates for the individual studies; limit lines, 95% CIs; and open diamonds, summary estimates for the group of studies pooled (the pooled estimate). Figure Legend:

3 Date of download: 6/24/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Combination Treatments for Psoriasis: A Systematic Review and Meta-analysis Arch Dermatol. 2012;148(4):511-522. doi:10.1001/archdermatol.2011.1916 Figure 3. Vitamin D derivative–corticosteroid combination therapy vs vitamin D derivative monotherapy clearance efficacy by corticosteroid potency class. When stratified by corticosteroid potency class, vitamin D derivative–corticosteroid combination treatment was more effective in inducing disease clearance than vitamin D derivative monotherapy when a class 1 or class 2 corticosteroid was used. It was not more effective when a class 3 corticosteroid was used. Weights are derived from random-effects analysis. Percentages might not total 100 because of rounding. The vertical dashed line indicates the summary estimate when all the studies in the table are pooled for a single estimate. RD indicates risk difference. Other symbols are explained in the legend to Figure 2. Figure Legend:

4 Date of download: 6/24/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Combination Treatments for Psoriasis: A Systematic Review and Meta-analysis Arch Dermatol. 2012;148(4):511-522. doi:10.1001/archdermatol.2011.1916 Figure 4. Vitamin A derivative combination therapies and disease clearance efficacy (risk difference [RD]). Vitamin A derivative– psoralen–UV-A (PUVA) combination treatment was more effective in inducing disease clearance than vitamin A derivative or PUVA monotherapies. Vitamin A derivative–corticosteroid combination therapy was more effective than vitamin A derivative monotherapy, and vitamin A derivative–UV-B combination therapy was more effective than UV-B monotherapy. Weights are derived from random- effects analysis. Percentages might not total 100 because of rounding. Symbols are explained in the legend to Figure 2. Figure Legend:

5 Date of download: 6/24/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Combination Treatments for Psoriasis: A Systematic Review and Meta-analysis Arch Dermatol. 2012;148(4):511-522. doi:10.1001/archdermatol.2011.1916 Figure 5. Vitamin A derivative–psoralen–UV-A (PUVA) combination therapy vs vitamin A derivative monotherapy clearance efficacy by blinding status. Among unblinded studies, vitamin A derivative–PUVA combination therapy led to a higher likelihood of disease clearance than vitamin A derivative monotherapy. This effect was not statistically significant among double-blinded studies. Weights are derived from random-effects analysis. Percentages might not total 100 because of rounding. The vertical dashed line indicates the summary estimate when all the studies in the table are pooled for a single estimate. RD indicates risk difference. Other symbols are explained in the legend to Figure 2. Figure Legend:

6 Date of download: 6/24/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Combination Treatments for Psoriasis: A Systematic Review and Meta-analysis Arch Dermatol. 2012;148(4):511-522. doi:10.1001/archdermatol.2011.1916 Figure 6. Vitamin A derivative–psoralen–UV-A (PUVA) combination therapy vs vitamin A derivative monotherapy clearance efficacy by psoriasis type. When stratified by type of psoriasis, vitamin A derivative–PUVA combination treatment was more effective than vitamin A derivative monotherapy in inducing disease clearance among patients with palmoplantar pustulosis but not for patients with other types of psoriasis. Weights are derived from random-effects analysis. RD indicates risk difference. Symbols are explained in the legend to Figure 2. Figure Legend:

7 Date of download: 6/24/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Combination Treatments for Psoriasis: A Systematic Review and Meta-analysis Arch Dermatol. 2012;148(4):511-522. doi:10.1001/archdermatol.2011.1916 Figure 7. Combination UV-B therapies and disease clearance efficacy (risk difference [RD]). Combination UV-B–alefacept therapy was more effective in inducing disease clearance than alefacept monotherapy, and combination UV-B–methotrexate therapy was more effective than UV-B monotherapy. Combination UV-B–balneotherapy, UV-B–psoralen, and UV-B–tar therapies were not more effective than UV-B monotherapy. Weights are derived from random-effects analysis. Percentages might not total 100 because of rounding. Symbols are explained in the legend to Figure 2. Figure Legend:

8 Date of download: 6/24/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Combination Treatments for Psoriasis: A Systematic Review and Meta-analysis Arch Dermatol. 2012;148(4):511-522. doi:10.1001/archdermatol.2011.1916 Figure 8. Combination corticosteroid derivative therapies and disease clearance efficacy (risk difference [RD]). Combination corticosteroid–hydrocolloid dressing therapy led to a higher likelihood of disease clearance than corticosteroid monotherapy. Combination corticosteroid–salicylic acid therapy was not more effective than corticosteroid monotherapy, and combination corticosteroid–UV-B therapy was not more effective than UV-B monotherapy. Weights are derived from random-effects analysis. Symbols are explained in the legend to Figure 2. Figure Legend:


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