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Interventions for rosacea: abridged updated Cochrane systematic review including GRADE assessments.

Br J Dermatol. 2015 Jun 22;

Authors: van Zuuren EJ, Fedorowicz Z

Rosacea is a common chronic facial dermatosis. This update of our Cochrane review on interventions for rosacea summarises the evidence, including GRADE assessments, of the effects of the currently available treatments. Searches included: Cochrane Skin Group Specialised Register, CENTRAL in The Cochrane Library, MEDLINE, EMBASE, Science Citation Index, and ongoing trials registries (July 2014). One hundred six randomised controlled trials (RCT's) with 13,631participants were included, a more than 80% increase since the last update in 2011. Pooling of data was feasible for a few outcomes; for topical metronidazole and azelaic acid and both appeared to be more effective than placebo (moderate and high quality evidence respectively). Topical ivermectin was more effective than placebo based on two studies (high quality evidence), and slightly more effective than metronidazole in one study. Brimonidine was more effective than vehicle in reducing erythema in rosacea (high quality evidence). Cyclosporine ophthalmic emulsion was effective for ocular rosacea (low quality evidence). For oral treatments there was moderate quality evidence for the effectiveness of tetracycline based on two old studies, and high quality evidence for doxycycline 40 mg compared to placebo according to physician assessments. One study at high risk of bias demonstrated equivalent effectiveness for azithromycin and doxycycline 100 mg. Minocycline 45 mg may be effective for papulopustular rosacea (low quality evidence). Low-dose isotretinoin appeared to be slightly more effective than doxycycline 50-100 mg (high quality evidence). Laser and light-based therapies for erythema in rosacea were effective (low quality evidence). Further RCT's are required for ocular rosacea. This article is protected by copyright. All rights reserved.

PMID: 26099423 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/26099423?dopt=Abstract = URL to article

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