1.Combination of excimer laser and topical treatment for psoriasis: A systematic review and meta-analysis.
Marie Len A. CAMACLANG ; Leah Antoinette M. CARO-CHANG ; Ma. Lorna F. FREZ
Acta Medica Philippina 2019;53(2):113-121
OBJECTIVES: To assess the efficacy and safety of excimer laser in combination with topical standard therapies for treatment of plaque-type psoriasis in comparison to excimer laser alone, standard topical treatment alone, or placebo.
METHODS: A literature search using Medline, Cochrane and HERDIN was conducted. Data were analyzed using mean difference at 95% confidence interval, with heterogeneity determined by I2 test.
RESULTS: Three articles with total of 130 patients fulfilled the inclusion criteria. Topical treatments studied were vitamin analog (calcipotriol), anthralin (dithranol), and steroid (flumethasone pivalate). A subgroup analysis comparing combination therapy and excimer laser alone showed a greater reduction in pooled PASI score reduction (-2.52; 95% CI: -4.28, -0.77) in the combination group after five to six weeks. There was also a significantly greater reduction in cumulative UVB dose (-3.29; 95% CI: -4.29, -2.30) needed for clearing in the combination group. Pigmentation was the commonly observed adverse event in both groups.
CONCLUSIONS: Excimer laser, in combination with topical treatment, is more effective than excimer laser alone, with significantly lower cumulative UVB dose, but the quality of current evidence is low. Long-term controlled trials are warranted to increase our confidence in the estimates of these outcomes.
Lasers, Excimer ; Psoriasis ; Calcipotriene ; Anthralin ; Flumethasone ; Meta-analysis ; Systematic Review