Scolaris Content Display Scolaris Content Display

Chronic plaque psoriasis
 Source: Dermis Dermatology Atlas Online (used with permission)
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Figure 1

Chronic plaque psoriasis
Source: Dermis Dermatology Atlas Online (used with permission)

The epidermis in the skin of people with and without psoriasis
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Figure 2

The epidermis in the skin of people with and without psoriasis

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
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Figure 3

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

Forest plot of comparison: 13 Vitamin D alone or in combination vs. other treatments: complex regimens, outcome: 13.5 Combined end point (IAGI/TSS/PASI/PAGI).
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Figure 4

Forest plot of comparison: 13 Vitamin D alone or in combination vs. other treatments: complex regimens, outcome: 13.5 Combined end point (IAGI/TSS/PASI/PAGI).

Forest plot of comparison: 14 Vitamin D alone or in combination vs. other treatment: long term studies (>24wks), outcome: 14.5 Combined end point (IAGI/TSS/PASI/PAGI).
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Figure 5

Forest plot of comparison: 14 Vitamin D alone or in combination vs. other treatment: long term studies (>24wks), outcome: 14.5 Combined end point (IAGI/TSS/PASI/PAGI).

Forest plot of comparison: 18 Scalp psoriasis: placebo‐controlled trials, outcome: 18.5 Combined end point (IAGI/TSS/PASI/PAGI).
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Figure 6

Forest plot of comparison: 18 Scalp psoriasis: placebo‐controlled trials, outcome: 18.5 Combined end point (IAGI/TSS/PASI/PAGI).

Comparison 1 Vitamin D analogues versus placebo, Outcome 1 IAGI.
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Analysis 1.1

Comparison 1 Vitamin D analogues versus placebo, Outcome 1 IAGI.

Comparison 1 Vitamin D analogues versus placebo, Outcome 2 TSS.
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Analysis 1.2

Comparison 1 Vitamin D analogues versus placebo, Outcome 2 TSS.

Comparison 1 Vitamin D analogues versus placebo, Outcome 3 PASI.
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Analysis 1.3

Comparison 1 Vitamin D analogues versus placebo, Outcome 3 PASI.

Comparison 1 Vitamin D analogues versus placebo, Outcome 4 PAGI.
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Analysis 1.4

Comparison 1 Vitamin D analogues versus placebo, Outcome 4 PAGI.

Comparison 1 Vitamin D analogues versus placebo, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).
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Analysis 1.5

Comparison 1 Vitamin D analogues versus placebo, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).

Comparison 1 Vitamin D analogues versus placebo, Outcome 6 Total withdrawals.
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Analysis 1.6

Comparison 1 Vitamin D analogues versus placebo, Outcome 6 Total withdrawals.

Comparison 1 Vitamin D analogues versus placebo, Outcome 7 Withdrawals due to adverse events.
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Analysis 1.7

Comparison 1 Vitamin D analogues versus placebo, Outcome 7 Withdrawals due to adverse events.

Comparison 1 Vitamin D analogues versus placebo, Outcome 8 Withdrawals due to treatment failure.
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Analysis 1.8

Comparison 1 Vitamin D analogues versus placebo, Outcome 8 Withdrawals due to treatment failure.

Comparison 1 Vitamin D analogues versus placebo, Outcome 9 Adverse events (local).
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Analysis 1.9

Comparison 1 Vitamin D analogues versus placebo, Outcome 9 Adverse events (local).

Comparison 1 Vitamin D analogues versus placebo, Outcome 10 Adverse events (systemic).
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Analysis 1.10

Comparison 1 Vitamin D analogues versus placebo, Outcome 10 Adverse events (systemic).

Comparison 2 Corticosteroid (potent) versus placebo, Outcome 1 IAGI.
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Analysis 2.1

Comparison 2 Corticosteroid (potent) versus placebo, Outcome 1 IAGI.

Comparison 2 Corticosteroid (potent) versus placebo, Outcome 2 TSS.
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Analysis 2.2

Comparison 2 Corticosteroid (potent) versus placebo, Outcome 2 TSS.

Comparison 2 Corticosteroid (potent) versus placebo, Outcome 3 PASI.
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Analysis 2.3

Comparison 2 Corticosteroid (potent) versus placebo, Outcome 3 PASI.

Comparison 2 Corticosteroid (potent) versus placebo, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).
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Analysis 2.5

Comparison 2 Corticosteroid (potent) versus placebo, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).

Comparison 2 Corticosteroid (potent) versus placebo, Outcome 6 Total withdrawals.
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Analysis 2.6

Comparison 2 Corticosteroid (potent) versus placebo, Outcome 6 Total withdrawals.

Comparison 2 Corticosteroid (potent) versus placebo, Outcome 7 Withdrawals due to adverse events.
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Analysis 2.7

Comparison 2 Corticosteroid (potent) versus placebo, Outcome 7 Withdrawals due to adverse events.

Comparison 2 Corticosteroid (potent) versus placebo, Outcome 8 Withdrawals due to treatment failure.
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Analysis 2.8

Comparison 2 Corticosteroid (potent) versus placebo, Outcome 8 Withdrawals due to treatment failure.

Comparison 2 Corticosteroid (potent) versus placebo, Outcome 9 Adverse events (local).
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Analysis 2.9

Comparison 2 Corticosteroid (potent) versus placebo, Outcome 9 Adverse events (local).

Comparison 2 Corticosteroid (potent) versus placebo, Outcome 10 Adverse events (systemic).
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Analysis 2.10

Comparison 2 Corticosteroid (potent) versus placebo, Outcome 10 Adverse events (systemic).

Comparison 3 Corticosteroid (very potent) versus placebo, Outcome 1 IAGI.
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Analysis 3.1

Comparison 3 Corticosteroid (very potent) versus placebo, Outcome 1 IAGI.

Comparison 3 Corticosteroid (very potent) versus placebo, Outcome 2 TSS.
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Analysis 3.2

Comparison 3 Corticosteroid (very potent) versus placebo, Outcome 2 TSS.

Comparison 3 Corticosteroid (very potent) versus placebo, Outcome 4 PAGI.
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Analysis 3.4

Comparison 3 Corticosteroid (very potent) versus placebo, Outcome 4 PAGI.

Comparison 3 Corticosteroid (very potent) versus placebo, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).
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Analysis 3.5

Comparison 3 Corticosteroid (very potent) versus placebo, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).

Comparison 3 Corticosteroid (very potent) versus placebo, Outcome 6 Total withdrawals.
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Analysis 3.6

Comparison 3 Corticosteroid (very potent) versus placebo, Outcome 6 Total withdrawals.

Comparison 3 Corticosteroid (very potent) versus placebo, Outcome 7 Withdrawals due to adverse events.
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Analysis 3.7

Comparison 3 Corticosteroid (very potent) versus placebo, Outcome 7 Withdrawals due to adverse events.

Comparison 3 Corticosteroid (very potent) versus placebo, Outcome 8 Withdrawals due to treatment failure.
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Analysis 3.8

Comparison 3 Corticosteroid (very potent) versus placebo, Outcome 8 Withdrawals due to treatment failure.

Comparison 3 Corticosteroid (very potent) versus placebo, Outcome 9 Adverse events (local).
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Analysis 3.9

Comparison 3 Corticosteroid (very potent) versus placebo, Outcome 9 Adverse events (local).

Comparison 3 Corticosteroid (very potent) versus placebo, Outcome 10 Adverse events (systemic).
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Analysis 3.10

Comparison 3 Corticosteroid (very potent) versus placebo, Outcome 10 Adverse events (systemic).

Comparison 4 Dithranol versus placebo, Outcome 2 TSS.
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Analysis 4.2

Comparison 4 Dithranol versus placebo, Outcome 2 TSS.

Comparison 4 Dithranol versus placebo, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).
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Analysis 4.5

Comparison 4 Dithranol versus placebo, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).

Comparison 4 Dithranol versus placebo, Outcome 6 Total withdrawals.
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Analysis 4.6

Comparison 4 Dithranol versus placebo, Outcome 6 Total withdrawals.

Comparison 4 Dithranol versus placebo, Outcome 7 Withdrawals due to adverse events.
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Analysis 4.7

Comparison 4 Dithranol versus placebo, Outcome 7 Withdrawals due to adverse events.

Comparison 4 Dithranol versus placebo, Outcome 8 Withdrawals due to treatment failure.
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Analysis 4.8

Comparison 4 Dithranol versus placebo, Outcome 8 Withdrawals due to treatment failure.

Comparison 4 Dithranol versus placebo, Outcome 9 Adverse events (local).
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Analysis 4.9

Comparison 4 Dithranol versus placebo, Outcome 9 Adverse events (local).

Comparison 4 Dithranol versus placebo, Outcome 10 Adverse events (systemic).
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Analysis 4.10

Comparison 4 Dithranol versus placebo, Outcome 10 Adverse events (systemic).

Comparison 5 Vitamin D combination products versus placebo, Outcome 1 IAGI.
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Analysis 5.1

Comparison 5 Vitamin D combination products versus placebo, Outcome 1 IAGI.

Comparison 5 Vitamin D combination products versus placebo, Outcome 3 PASI.
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Analysis 5.3

Comparison 5 Vitamin D combination products versus placebo, Outcome 3 PASI.

Comparison 5 Vitamin D combination products versus placebo, Outcome 4 PAGI.
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Analysis 5.4

Comparison 5 Vitamin D combination products versus placebo, Outcome 4 PAGI.

Comparison 5 Vitamin D combination products versus placebo, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).
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Analysis 5.5

Comparison 5 Vitamin D combination products versus placebo, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).

Comparison 5 Vitamin D combination products versus placebo, Outcome 6 Total withdrawals.
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Analysis 5.6

Comparison 5 Vitamin D combination products versus placebo, Outcome 6 Total withdrawals.

Comparison 5 Vitamin D combination products versus placebo, Outcome 7 Withdrawals due to adverse events.
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Analysis 5.7

Comparison 5 Vitamin D combination products versus placebo, Outcome 7 Withdrawals due to adverse events.

Comparison 5 Vitamin D combination products versus placebo, Outcome 8 Withdrawals due to treatment failure.
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Analysis 5.8

Comparison 5 Vitamin D combination products versus placebo, Outcome 8 Withdrawals due to treatment failure.

Comparison 5 Vitamin D combination products versus placebo, Outcome 9 Adverse events (local).
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Analysis 5.9

Comparison 5 Vitamin D combination products versus placebo, Outcome 9 Adverse events (local).

Comparison 5 Vitamin D combination products versus placebo, Outcome 10 Adverse events (systemic).
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Analysis 5.10

Comparison 5 Vitamin D combination products versus placebo, Outcome 10 Adverse events (systemic).

Comparison 6 Other treatment versus placebo, Outcome 1 IAGI.
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Analysis 6.1

Comparison 6 Other treatment versus placebo, Outcome 1 IAGI.

Comparison 6 Other treatment versus placebo, Outcome 2 TSS.
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Analysis 6.2

Comparison 6 Other treatment versus placebo, Outcome 2 TSS.

Comparison 6 Other treatment versus placebo, Outcome 3 PASI.
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Analysis 6.3

Comparison 6 Other treatment versus placebo, Outcome 3 PASI.

Comparison 6 Other treatment versus placebo, Outcome 4 PAGI.
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Analysis 6.4

Comparison 6 Other treatment versus placebo, Outcome 4 PAGI.

Comparison 6 Other treatment versus placebo, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).
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Analysis 6.5

Comparison 6 Other treatment versus placebo, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).

Comparison 6 Other treatment versus placebo, Outcome 6 Total withdrawals.
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Analysis 6.6

Comparison 6 Other treatment versus placebo, Outcome 6 Total withdrawals.

Comparison 6 Other treatment versus placebo, Outcome 7 Withdrawals due to adverse events.
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Analysis 6.7

Comparison 6 Other treatment versus placebo, Outcome 7 Withdrawals due to adverse events.

Comparison 6 Other treatment versus placebo, Outcome 8 Withdrawals due to treatment failure.
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Analysis 6.8

Comparison 6 Other treatment versus placebo, Outcome 8 Withdrawals due to treatment failure.

Comparison 6 Other treatment versus placebo, Outcome 9 Adverse events (local).
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Analysis 6.9

Comparison 6 Other treatment versus placebo, Outcome 9 Adverse events (local).

Comparison 6 Other treatment versus placebo, Outcome 10 Adverse events (systemic).
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Analysis 6.10

Comparison 6 Other treatment versus placebo, Outcome 10 Adverse events (systemic).

Comparison 7 Vitamin D analogues versus corticosteroid (potent), Outcome 1 IAGI.
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Analysis 7.1

Comparison 7 Vitamin D analogues versus corticosteroid (potent), Outcome 1 IAGI.

Comparison 7 Vitamin D analogues versus corticosteroid (potent), Outcome 2 TSS.
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Analysis 7.2

Comparison 7 Vitamin D analogues versus corticosteroid (potent), Outcome 2 TSS.

Comparison 7 Vitamin D analogues versus corticosteroid (potent), Outcome 3 PASI.
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Analysis 7.3

Comparison 7 Vitamin D analogues versus corticosteroid (potent), Outcome 3 PASI.

Comparison 7 Vitamin D analogues versus corticosteroid (potent), Outcome 4 PAGI.
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Analysis 7.4

Comparison 7 Vitamin D analogues versus corticosteroid (potent), Outcome 4 PAGI.

Comparison 7 Vitamin D analogues versus corticosteroid (potent), Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).
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Analysis 7.5

Comparison 7 Vitamin D analogues versus corticosteroid (potent), Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).

Comparison 7 Vitamin D analogues versus corticosteroid (potent), Outcome 6 Total withdrawals.
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Analysis 7.6

Comparison 7 Vitamin D analogues versus corticosteroid (potent), Outcome 6 Total withdrawals.

Comparison 7 Vitamin D analogues versus corticosteroid (potent), Outcome 7 Withdrawals due to adverse events.
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Analysis 7.7

Comparison 7 Vitamin D analogues versus corticosteroid (potent), Outcome 7 Withdrawals due to adverse events.

Comparison 7 Vitamin D analogues versus corticosteroid (potent), Outcome 8 Withdrawals due to treatment failure.
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Analysis 7.8

Comparison 7 Vitamin D analogues versus corticosteroid (potent), Outcome 8 Withdrawals due to treatment failure.

Comparison 7 Vitamin D analogues versus corticosteroid (potent), Outcome 9 Adverse events (local).
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Analysis 7.9

Comparison 7 Vitamin D analogues versus corticosteroid (potent), Outcome 9 Adverse events (local).

Comparison 7 Vitamin D analogues versus corticosteroid (potent), Outcome 10 Adverse events (systemic).
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Analysis 7.10

Comparison 7 Vitamin D analogues versus corticosteroid (potent), Outcome 10 Adverse events (systemic).

Comparison 8 Vitamin D analogues versus corticosteroid (very potent), Outcome 1 IAGI.
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Analysis 8.1

Comparison 8 Vitamin D analogues versus corticosteroid (very potent), Outcome 1 IAGI.

Comparison 8 Vitamin D analogues versus corticosteroid (very potent), Outcome 3 PASI.
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Analysis 8.3

Comparison 8 Vitamin D analogues versus corticosteroid (very potent), Outcome 3 PASI.

Comparison 8 Vitamin D analogues versus corticosteroid (very potent), Outcome 4 PAGI.
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Analysis 8.4

Comparison 8 Vitamin D analogues versus corticosteroid (very potent), Outcome 4 PAGI.

Comparison 8 Vitamin D analogues versus corticosteroid (very potent), Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).
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Analysis 8.5

Comparison 8 Vitamin D analogues versus corticosteroid (very potent), Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).

Comparison 8 Vitamin D analogues versus corticosteroid (very potent), Outcome 6 Total withdrawals.
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Analysis 8.6

Comparison 8 Vitamin D analogues versus corticosteroid (very potent), Outcome 6 Total withdrawals.

Comparison 8 Vitamin D analogues versus corticosteroid (very potent), Outcome 7 Withdrawals due to adverse events.
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Analysis 8.7

Comparison 8 Vitamin D analogues versus corticosteroid (very potent), Outcome 7 Withdrawals due to adverse events.

Comparison 8 Vitamin D analogues versus corticosteroid (very potent), Outcome 8 Withdrawals due to treatment failure.
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Analysis 8.8

Comparison 8 Vitamin D analogues versus corticosteroid (very potent), Outcome 8 Withdrawals due to treatment failure.

Comparison 8 Vitamin D analogues versus corticosteroid (very potent), Outcome 9 Adverse events (local).
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Analysis 8.9

Comparison 8 Vitamin D analogues versus corticosteroid (very potent), Outcome 9 Adverse events (local).

Comparison 8 Vitamin D analogues versus corticosteroid (very potent), Outcome 10 Adverse events (systemic).
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Analysis 8.10

Comparison 8 Vitamin D analogues versus corticosteroid (very potent), Outcome 10 Adverse events (systemic).

Comparison 9 Vitamin D combined with corticosteroid versus corticosteroid, Outcome 1 IAGI.
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Analysis 9.1

Comparison 9 Vitamin D combined with corticosteroid versus corticosteroid, Outcome 1 IAGI.

Comparison 9 Vitamin D combined with corticosteroid versus corticosteroid, Outcome 2 TSS.
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Analysis 9.2

Comparison 9 Vitamin D combined with corticosteroid versus corticosteroid, Outcome 2 TSS.

Comparison 9 Vitamin D combined with corticosteroid versus corticosteroid, Outcome 3 PASI.
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Analysis 9.3

Comparison 9 Vitamin D combined with corticosteroid versus corticosteroid, Outcome 3 PASI.

Comparison 9 Vitamin D combined with corticosteroid versus corticosteroid, Outcome 4 PAGI.
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Analysis 9.4

Comparison 9 Vitamin D combined with corticosteroid versus corticosteroid, Outcome 4 PAGI.

Comparison 9 Vitamin D combined with corticosteroid versus corticosteroid, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).
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Analysis 9.5

Comparison 9 Vitamin D combined with corticosteroid versus corticosteroid, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).

Comparison 9 Vitamin D combined with corticosteroid versus corticosteroid, Outcome 6 Total withdrawals.
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Analysis 9.6

Comparison 9 Vitamin D combined with corticosteroid versus corticosteroid, Outcome 6 Total withdrawals.

Comparison 9 Vitamin D combined with corticosteroid versus corticosteroid, Outcome 7 Withdrawals due to adverse events.
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Analysis 9.7

Comparison 9 Vitamin D combined with corticosteroid versus corticosteroid, Outcome 7 Withdrawals due to adverse events.

Comparison 9 Vitamin D combined with corticosteroid versus corticosteroid, Outcome 8 Withdrawals due to treatment failure.
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Analysis 9.8

Comparison 9 Vitamin D combined with corticosteroid versus corticosteroid, Outcome 8 Withdrawals due to treatment failure.

Comparison 9 Vitamin D combined with corticosteroid versus corticosteroid, Outcome 9 Adverse events (local).
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Analysis 9.9

Comparison 9 Vitamin D combined with corticosteroid versus corticosteroid, Outcome 9 Adverse events (local).

Comparison 9 Vitamin D combined with corticosteroid versus corticosteroid, Outcome 10 Adverse events (systemic).
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Analysis 9.10

Comparison 9 Vitamin D combined with corticosteroid versus corticosteroid, Outcome 10 Adverse events (systemic).

Comparison 10 Vitamin D alone or in combination versus dithranol, Outcome 1 IAGI.
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Analysis 10.1

Comparison 10 Vitamin D alone or in combination versus dithranol, Outcome 1 IAGI.

Comparison 10 Vitamin D alone or in combination versus dithranol, Outcome 2 TSS.
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Analysis 10.2

Comparison 10 Vitamin D alone or in combination versus dithranol, Outcome 2 TSS.

Comparison 10 Vitamin D alone or in combination versus dithranol, Outcome 3 PASI.
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Analysis 10.3

Comparison 10 Vitamin D alone or in combination versus dithranol, Outcome 3 PASI.

Comparison 10 Vitamin D alone or in combination versus dithranol, Outcome 4 PAGI.
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Analysis 10.4

Comparison 10 Vitamin D alone or in combination versus dithranol, Outcome 4 PAGI.

Comparison 10 Vitamin D alone or in combination versus dithranol, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).
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Analysis 10.5

Comparison 10 Vitamin D alone or in combination versus dithranol, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).

Comparison 10 Vitamin D alone or in combination versus dithranol, Outcome 6 Total withdrawals.
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Analysis 10.6

Comparison 10 Vitamin D alone or in combination versus dithranol, Outcome 6 Total withdrawals.

Comparison 10 Vitamin D alone or in combination versus dithranol, Outcome 7 Withdrawals due to adverse events.
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Analysis 10.7

Comparison 10 Vitamin D alone or in combination versus dithranol, Outcome 7 Withdrawals due to adverse events.

Comparison 10 Vitamin D alone or in combination versus dithranol, Outcome 8 Withdrawals due to treatment failure.
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Analysis 10.8

Comparison 10 Vitamin D alone or in combination versus dithranol, Outcome 8 Withdrawals due to treatment failure.

Comparison 10 Vitamin D alone or in combination versus dithranol, Outcome 9 Adverse events (local).
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Analysis 10.9

Comparison 10 Vitamin D alone or in combination versus dithranol, Outcome 9 Adverse events (local).

Comparison 10 Vitamin D alone or in combination versus dithranol, Outcome 10 Adverse events (systemic).
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Analysis 10.10

Comparison 10 Vitamin D alone or in combination versus dithranol, Outcome 10 Adverse events (systemic).

Comparison 11 Vitamin D alone or in combination versus other vitamin D analogue, Outcome 1 IAGI.
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Analysis 11.1

Comparison 11 Vitamin D alone or in combination versus other vitamin D analogue, Outcome 1 IAGI.

Comparison 11 Vitamin D alone or in combination versus other vitamin D analogue, Outcome 2 TSS.
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Analysis 11.2

Comparison 11 Vitamin D alone or in combination versus other vitamin D analogue, Outcome 2 TSS.

Comparison 11 Vitamin D alone or in combination versus other vitamin D analogue, Outcome 3 PASI.
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Analysis 11.3

Comparison 11 Vitamin D alone or in combination versus other vitamin D analogue, Outcome 3 PASI.

Comparison 11 Vitamin D alone or in combination versus other vitamin D analogue, Outcome 4 PAGI.
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Analysis 11.4

Comparison 11 Vitamin D alone or in combination versus other vitamin D analogue, Outcome 4 PAGI.

Comparison 11 Vitamin D alone or in combination versus other vitamin D analogue, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).
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Analysis 11.5

Comparison 11 Vitamin D alone or in combination versus other vitamin D analogue, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).

Comparison 11 Vitamin D alone or in combination versus other vitamin D analogue, Outcome 6 Total withdrawals.
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Analysis 11.6

Comparison 11 Vitamin D alone or in combination versus other vitamin D analogue, Outcome 6 Total withdrawals.

Comparison 11 Vitamin D alone or in combination versus other vitamin D analogue, Outcome 7 Withdrawals due to adverse events.
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Analysis 11.7

Comparison 11 Vitamin D alone or in combination versus other vitamin D analogue, Outcome 7 Withdrawals due to adverse events.

Comparison 11 Vitamin D alone or in combination versus other vitamin D analogue, Outcome 8 Withdrawals due to treatment failure.
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Analysis 11.8

Comparison 11 Vitamin D alone or in combination versus other vitamin D analogue, Outcome 8 Withdrawals due to treatment failure.

Comparison 11 Vitamin D alone or in combination versus other vitamin D analogue, Outcome 9 Adverse events (local).
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Analysis 11.9

Comparison 11 Vitamin D alone or in combination versus other vitamin D analogue, Outcome 9 Adverse events (local).

Comparison 11 Vitamin D alone or in combination versus other vitamin D analogue, Outcome 10 Adverse events (systemic).
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Analysis 11.10

Comparison 11 Vitamin D alone or in combination versus other vitamin D analogue, Outcome 10 Adverse events (systemic).

Comparison 12 Vitamin D alone or in combination versus vitamin D + corticosteroid, Outcome 1 IAGI.
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Analysis 12.1

Comparison 12 Vitamin D alone or in combination versus vitamin D + corticosteroid, Outcome 1 IAGI.

Comparison 12 Vitamin D alone or in combination versus vitamin D + corticosteroid, Outcome 2 TSS.
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Analysis 12.2

Comparison 12 Vitamin D alone or in combination versus vitamin D + corticosteroid, Outcome 2 TSS.

Comparison 12 Vitamin D alone or in combination versus vitamin D + corticosteroid, Outcome 3 PASI.
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Analysis 12.3

Comparison 12 Vitamin D alone or in combination versus vitamin D + corticosteroid, Outcome 3 PASI.

Comparison 12 Vitamin D alone or in combination versus vitamin D + corticosteroid, Outcome 4 PAGI.
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Analysis 12.4

Comparison 12 Vitamin D alone or in combination versus vitamin D + corticosteroid, Outcome 4 PAGI.

Comparison 12 Vitamin D alone or in combination versus vitamin D + corticosteroid, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).
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Analysis 12.5

Comparison 12 Vitamin D alone or in combination versus vitamin D + corticosteroid, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).

Comparison 12 Vitamin D alone or in combination versus vitamin D + corticosteroid, Outcome 6 Total withdrawals.
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Analysis 12.6

Comparison 12 Vitamin D alone or in combination versus vitamin D + corticosteroid, Outcome 6 Total withdrawals.

Comparison 12 Vitamin D alone or in combination versus vitamin D + corticosteroid, Outcome 7 Withdrawals due to adverse events.
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Analysis 12.7

Comparison 12 Vitamin D alone or in combination versus vitamin D + corticosteroid, Outcome 7 Withdrawals due to adverse events.

Comparison 12 Vitamin D alone or in combination versus vitamin D + corticosteroid, Outcome 8 Withdrawals due to treatment failure.
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Analysis 12.8

Comparison 12 Vitamin D alone or in combination versus vitamin D + corticosteroid, Outcome 8 Withdrawals due to treatment failure.

Comparison 12 Vitamin D alone or in combination versus vitamin D + corticosteroid, Outcome 9 Adverse events (local).
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Analysis 12.9

Comparison 12 Vitamin D alone or in combination versus vitamin D + corticosteroid, Outcome 9 Adverse events (local).

Comparison 12 Vitamin D alone or in combination versus vitamin D + corticosteroid, Outcome 10 Adverse events (systemic).
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Analysis 12.10

Comparison 12 Vitamin D alone or in combination versus vitamin D + corticosteroid, Outcome 10 Adverse events (systemic).

Comparison 13 Vitamin D alone or in combination versus other treatments: complex regimens, Outcome 1 IAGI.
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Analysis 13.1

Comparison 13 Vitamin D alone or in combination versus other treatments: complex regimens, Outcome 1 IAGI.

Comparison 13 Vitamin D alone or in combination versus other treatments: complex regimens, Outcome 2 TSS.
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Analysis 13.2

Comparison 13 Vitamin D alone or in combination versus other treatments: complex regimens, Outcome 2 TSS.

Comparison 13 Vitamin D alone or in combination versus other treatments: complex regimens, Outcome 3 PASI.
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Analysis 13.3

Comparison 13 Vitamin D alone or in combination versus other treatments: complex regimens, Outcome 3 PASI.

Comparison 13 Vitamin D alone or in combination versus other treatments: complex regimens, Outcome 4 PAGI.
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Analysis 13.4

Comparison 13 Vitamin D alone or in combination versus other treatments: complex regimens, Outcome 4 PAGI.

Comparison 13 Vitamin D alone or in combination versus other treatments: complex regimens, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).
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Analysis 13.5

Comparison 13 Vitamin D alone or in combination versus other treatments: complex regimens, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).

Comparison 13 Vitamin D alone or in combination versus other treatments: complex regimens, Outcome 6 Total withdrawals.
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Analysis 13.6

Comparison 13 Vitamin D alone or in combination versus other treatments: complex regimens, Outcome 6 Total withdrawals.

Comparison 13 Vitamin D alone or in combination versus other treatments: complex regimens, Outcome 7 Withdrawals due to adverse events.
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Analysis 13.7

Comparison 13 Vitamin D alone or in combination versus other treatments: complex regimens, Outcome 7 Withdrawals due to adverse events.

Comparison 13 Vitamin D alone or in combination versus other treatments: complex regimens, Outcome 8 Withdrawals due to treatment failure.
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Analysis 13.8

Comparison 13 Vitamin D alone or in combination versus other treatments: complex regimens, Outcome 8 Withdrawals due to treatment failure.

Comparison 13 Vitamin D alone or in combination versus other treatments: complex regimens, Outcome 9 Adverse events (local).
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Analysis 13.9

Comparison 13 Vitamin D alone or in combination versus other treatments: complex regimens, Outcome 9 Adverse events (local).

Comparison 14 Vitamin D alone or in combination versus other treatment: long‐term studies (> 24 wks), Outcome 1 IAGI.
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Analysis 14.1

Comparison 14 Vitamin D alone or in combination versus other treatment: long‐term studies (> 24 wks), Outcome 1 IAGI.

Comparison 14 Vitamin D alone or in combination versus other treatment: long‐term studies (> 24 wks), Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).
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Analysis 14.5

Comparison 14 Vitamin D alone or in combination versus other treatment: long‐term studies (> 24 wks), Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).

Comparison 14 Vitamin D alone or in combination versus other treatment: long‐term studies (> 24 wks), Outcome 6 Total withdrawals.
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Analysis 14.6

Comparison 14 Vitamin D alone or in combination versus other treatment: long‐term studies (> 24 wks), Outcome 6 Total withdrawals.

Comparison 14 Vitamin D alone or in combination versus other treatment: long‐term studies (> 24 wks), Outcome 7 Withdrawals due to adverse events.
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Analysis 14.7

Comparison 14 Vitamin D alone or in combination versus other treatment: long‐term studies (> 24 wks), Outcome 7 Withdrawals due to adverse events.

Comparison 14 Vitamin D alone or in combination versus other treatment: long‐term studies (> 24 wks), Outcome 8 Withdrawals due to treatment failure.
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Analysis 14.8

Comparison 14 Vitamin D alone or in combination versus other treatment: long‐term studies (> 24 wks), Outcome 8 Withdrawals due to treatment failure.

Comparison 14 Vitamin D alone or in combination versus other treatment: long‐term studies (> 24 wks), Outcome 9 Adverse events (local).
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Analysis 14.9

Comparison 14 Vitamin D alone or in combination versus other treatment: long‐term studies (> 24 wks), Outcome 9 Adverse events (local).

Comparison 15 Vitamin D analogues versus other treatment, Outcome 1 IAGI.
Figures and Tables -
Analysis 15.1

Comparison 15 Vitamin D analogues versus other treatment, Outcome 1 IAGI.

Comparison 15 Vitamin D analogues versus other treatment, Outcome 2 TSS.
Figures and Tables -
Analysis 15.2

Comparison 15 Vitamin D analogues versus other treatment, Outcome 2 TSS.

Comparison 15 Vitamin D analogues versus other treatment, Outcome 3 PASI.
Figures and Tables -
Analysis 15.3

Comparison 15 Vitamin D analogues versus other treatment, Outcome 3 PASI.

Comparison 15 Vitamin D analogues versus other treatment, Outcome 4 PAGI.
Figures and Tables -
Analysis 15.4

Comparison 15 Vitamin D analogues versus other treatment, Outcome 4 PAGI.

Comparison 15 Vitamin D analogues versus other treatment, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).
Figures and Tables -
Analysis 15.5

Comparison 15 Vitamin D analogues versus other treatment, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).

Comparison 15 Vitamin D analogues versus other treatment, Outcome 6 Total withdrawals.
Figures and Tables -
Analysis 15.6

Comparison 15 Vitamin D analogues versus other treatment, Outcome 6 Total withdrawals.

Comparison 15 Vitamin D analogues versus other treatment, Outcome 7 Withdrawals due to adverse events.
Figures and Tables -
Analysis 15.7

Comparison 15 Vitamin D analogues versus other treatment, Outcome 7 Withdrawals due to adverse events.

Comparison 15 Vitamin D analogues versus other treatment, Outcome 8 Withdrawals due to treatment failure.
Figures and Tables -
Analysis 15.8

Comparison 15 Vitamin D analogues versus other treatment, Outcome 8 Withdrawals due to treatment failure.

Comparison 15 Vitamin D analogues versus other treatment, Outcome 9 Adverse events (local).
Figures and Tables -
Analysis 15.9

Comparison 15 Vitamin D analogues versus other treatment, Outcome 9 Adverse events (local).

Comparison 15 Vitamin D analogues versus other treatment, Outcome 10 Adverse events (systemic).
Figures and Tables -
Analysis 15.10

Comparison 15 Vitamin D analogues versus other treatment, Outcome 10 Adverse events (systemic).

Comparison 16 Flexural/facial psoriasis: placebo‐controlled trials, Outcome 1 IAGI.
Figures and Tables -
Analysis 16.1

Comparison 16 Flexural/facial psoriasis: placebo‐controlled trials, Outcome 1 IAGI.

Comparison 16 Flexural/facial psoriasis: placebo‐controlled trials, Outcome 2 TSS.
Figures and Tables -
Analysis 16.2

Comparison 16 Flexural/facial psoriasis: placebo‐controlled trials, Outcome 2 TSS.

Comparison 16 Flexural/facial psoriasis: placebo‐controlled trials, Outcome 3 PASI.
Figures and Tables -
Analysis 16.3

Comparison 16 Flexural/facial psoriasis: placebo‐controlled trials, Outcome 3 PASI.

Comparison 16 Flexural/facial psoriasis: placebo‐controlled trials, Outcome 4 PAGI.
Figures and Tables -
Analysis 16.4

Comparison 16 Flexural/facial psoriasis: placebo‐controlled trials, Outcome 4 PAGI.

Comparison 16 Flexural/facial psoriasis: placebo‐controlled trials, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).
Figures and Tables -
Analysis 16.5

Comparison 16 Flexural/facial psoriasis: placebo‐controlled trials, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).

Comparison 16 Flexural/facial psoriasis: placebo‐controlled trials, Outcome 6 Total withdrawals.
Figures and Tables -
Analysis 16.6

Comparison 16 Flexural/facial psoriasis: placebo‐controlled trials, Outcome 6 Total withdrawals.

Comparison 16 Flexural/facial psoriasis: placebo‐controlled trials, Outcome 7 Withdrawals due to adverse events.
Figures and Tables -
Analysis 16.7

Comparison 16 Flexural/facial psoriasis: placebo‐controlled trials, Outcome 7 Withdrawals due to adverse events.

Comparison 16 Flexural/facial psoriasis: placebo‐controlled trials, Outcome 8 Withdrawals due to treatment failure.
Figures and Tables -
Analysis 16.8

Comparison 16 Flexural/facial psoriasis: placebo‐controlled trials, Outcome 8 Withdrawals due to treatment failure.

Comparison 16 Flexural/facial psoriasis: placebo‐controlled trials, Outcome 9 Adverse events (local).
Figures and Tables -
Analysis 16.9

Comparison 16 Flexural/facial psoriasis: placebo‐controlled trials, Outcome 9 Adverse events (local).

Comparison 16 Flexural/facial psoriasis: placebo‐controlled trials, Outcome 10 Adverse events (systemic).
Figures and Tables -
Analysis 16.10

Comparison 16 Flexural/facial psoriasis: placebo‐controlled trials, Outcome 10 Adverse events (systemic).

Comparison 17 Flexural/facial psoriasis: vitamin D alone or in combination versus other treatment, Outcome 1 IAGI.
Figures and Tables -
Analysis 17.1

Comparison 17 Flexural/facial psoriasis: vitamin D alone or in combination versus other treatment, Outcome 1 IAGI.

Comparison 17 Flexural/facial psoriasis: vitamin D alone or in combination versus other treatment, Outcome 2 TSS.
Figures and Tables -
Analysis 17.2

Comparison 17 Flexural/facial psoriasis: vitamin D alone or in combination versus other treatment, Outcome 2 TSS.

Comparison 17 Flexural/facial psoriasis: vitamin D alone or in combination versus other treatment, Outcome 3 PASI.
Figures and Tables -
Analysis 17.3

Comparison 17 Flexural/facial psoriasis: vitamin D alone or in combination versus other treatment, Outcome 3 PASI.

Comparison 17 Flexural/facial psoriasis: vitamin D alone or in combination versus other treatment, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).
Figures and Tables -
Analysis 17.5

Comparison 17 Flexural/facial psoriasis: vitamin D alone or in combination versus other treatment, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).

Comparison 17 Flexural/facial psoriasis: vitamin D alone or in combination versus other treatment, Outcome 6 Total withdrawals.
Figures and Tables -
Analysis 17.6

Comparison 17 Flexural/facial psoriasis: vitamin D alone or in combination versus other treatment, Outcome 6 Total withdrawals.

Comparison 17 Flexural/facial psoriasis: vitamin D alone or in combination versus other treatment, Outcome 7 Withdrawals due to adverse events.
Figures and Tables -
Analysis 17.7

Comparison 17 Flexural/facial psoriasis: vitamin D alone or in combination versus other treatment, Outcome 7 Withdrawals due to adverse events.

Comparison 17 Flexural/facial psoriasis: vitamin D alone or in combination versus other treatment, Outcome 8 Withdrawals due to treatment failure.
Figures and Tables -
Analysis 17.8

Comparison 17 Flexural/facial psoriasis: vitamin D alone or in combination versus other treatment, Outcome 8 Withdrawals due to treatment failure.

Comparison 17 Flexural/facial psoriasis: vitamin D alone or in combination versus other treatment, Outcome 9 Adverse events (local).
Figures and Tables -
Analysis 17.9

Comparison 17 Flexural/facial psoriasis: vitamin D alone or in combination versus other treatment, Outcome 9 Adverse events (local).

Comparison 18 Scalp psoriasis: placebo‐controlled trials, Outcome 1 IAGI.
Figures and Tables -
Analysis 18.1

Comparison 18 Scalp psoriasis: placebo‐controlled trials, Outcome 1 IAGI.

Comparison 18 Scalp psoriasis: placebo‐controlled trials, Outcome 2 TSS.
Figures and Tables -
Analysis 18.2

Comparison 18 Scalp psoriasis: placebo‐controlled trials, Outcome 2 TSS.

Comparison 18 Scalp psoriasis: placebo‐controlled trials, Outcome 4 PAGI.
Figures and Tables -
Analysis 18.4

Comparison 18 Scalp psoriasis: placebo‐controlled trials, Outcome 4 PAGI.

Comparison 18 Scalp psoriasis: placebo‐controlled trials, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).
Figures and Tables -
Analysis 18.5

Comparison 18 Scalp psoriasis: placebo‐controlled trials, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).

Comparison 18 Scalp psoriasis: placebo‐controlled trials, Outcome 6 Total withdrawals.
Figures and Tables -
Analysis 18.6

Comparison 18 Scalp psoriasis: placebo‐controlled trials, Outcome 6 Total withdrawals.

Comparison 18 Scalp psoriasis: placebo‐controlled trials, Outcome 7 Withdrawals due to adverse events.
Figures and Tables -
Analysis 18.7

Comparison 18 Scalp psoriasis: placebo‐controlled trials, Outcome 7 Withdrawals due to adverse events.

Comparison 18 Scalp psoriasis: placebo‐controlled trials, Outcome 8 Withdrawals due to treatment failure.
Figures and Tables -
Analysis 18.8

Comparison 18 Scalp psoriasis: placebo‐controlled trials, Outcome 8 Withdrawals due to treatment failure.

Comparison 18 Scalp psoriasis: placebo‐controlled trials, Outcome 9 Adverse events (local).
Figures and Tables -
Analysis 18.9

Comparison 18 Scalp psoriasis: placebo‐controlled trials, Outcome 9 Adverse events (local).

Comparison 18 Scalp psoriasis: placebo‐controlled trials, Outcome 10 Adverse events (systemic).
Figures and Tables -
Analysis 18.10

Comparison 18 Scalp psoriasis: placebo‐controlled trials, Outcome 10 Adverse events (systemic).

Comparison 19 Scalp psoriasis: vitamin D alone or in combination versus other treatments, Outcome 1 IAGI.
Figures and Tables -
Analysis 19.1

Comparison 19 Scalp psoriasis: vitamin D alone or in combination versus other treatments, Outcome 1 IAGI.

Comparison 19 Scalp psoriasis: vitamin D alone or in combination versus other treatments, Outcome 2 TSS.
Figures and Tables -
Analysis 19.2

Comparison 19 Scalp psoriasis: vitamin D alone or in combination versus other treatments, Outcome 2 TSS.

Comparison 19 Scalp psoriasis: vitamin D alone or in combination versus other treatments, Outcome 4 PAGI.
Figures and Tables -
Analysis 19.4

Comparison 19 Scalp psoriasis: vitamin D alone or in combination versus other treatments, Outcome 4 PAGI.

Comparison 19 Scalp psoriasis: vitamin D alone or in combination versus other treatments, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).
Figures and Tables -
Analysis 19.5

Comparison 19 Scalp psoriasis: vitamin D alone or in combination versus other treatments, Outcome 5 Combined end point (IAGI/TSS/PASI/PAGI).

Comparison 19 Scalp psoriasis: vitamin D alone or in combination versus other treatments, Outcome 6 Total withdrawals.
Figures and Tables -
Analysis 19.6

Comparison 19 Scalp psoriasis: vitamin D alone or in combination versus other treatments, Outcome 6 Total withdrawals.

Comparison 19 Scalp psoriasis: vitamin D alone or in combination versus other treatments, Outcome 7 Withdrawals due to adverse events.
Figures and Tables -
Analysis 19.7

Comparison 19 Scalp psoriasis: vitamin D alone or in combination versus other treatments, Outcome 7 Withdrawals due to adverse events.

Comparison 19 Scalp psoriasis: vitamin D alone or in combination versus other treatments, Outcome 8 Withdrawals due to treatment failure.
Figures and Tables -
Analysis 19.8

Comparison 19 Scalp psoriasis: vitamin D alone or in combination versus other treatments, Outcome 8 Withdrawals due to treatment failure.

Comparison 19 Scalp psoriasis: vitamin D alone or in combination versus other treatments, Outcome 9 Adverse events (local).
Figures and Tables -
Analysis 19.9

Comparison 19 Scalp psoriasis: vitamin D alone or in combination versus other treatments, Outcome 9 Adverse events (local).

Comparison 19 Scalp psoriasis: vitamin D alone or in combination versus other treatments, Outcome 10 Adverse events (systemic).
Figures and Tables -
Analysis 19.10

Comparison 19 Scalp psoriasis: vitamin D alone or in combination versus other treatments, Outcome 10 Adverse events (systemic).

Table 1. List of acronyms

Acronym

Full name

BC

baseline comparability demonstrated (clinical/demographic)

BD

twice daily

BMD

betamethasone dipropionate

BMV

betamethasone valerate

BSA

Body Surface Area

Btw‐patient

Between‐patient

CI

confidence interval

dys

days

EQ‐5D

EuroQOL

FU

follow up (includes treatment period)

heterogeneity statistic

IAGI

Investigator Assessment of Global Improvement (change score)

IGA

Investigator Global Assessment (static score)

IQR

interquartile range

ISGA

Investigator's Static Global Assessment Score

LAE

local adverse effects

LCD

liquor carbonis distillate

LF

loss to follow up (per cent of participants randomised, not contributing to primary outcome measure)

MEMS

Medication Event Monitoring System

mPASI

modified Psoriasis Area Severity Index

NA

not available/not applicable

NR

not reported

OD

once daily

OM

once in the morning

ON

once at night

ODS

overall disease severity

PAGI

Patient Assessment of Global Improvement (change score)

PASI

Psoriasis Area Severity Index

PDI

Psoriasis Disability Index

PGA

Patient Global Assessment (static score)

PMAQ‐3w

Medication Adherence Questionnaire, version 3W

pt

point

QOL

quality of life

RD

risk difference

SD

standard deviation

SMD

standardised mean difference

TCP

two‐compound product

TD

three times daily

TLPSS

Total Local Psoriasis Severity Score

TSS

Total Severity Score/total sum score

UV

ultra violet

VDRE

Vitamin D‐Responsive Element

wks

weeks

yrs

years

Figures and Tables -
Table 1. List of acronyms
Table 2. Overview of outcome measures on effectiveness

Outcome

Acronym

Construct

Scale, minimum

Scale, maximum

Notes

* Investigator's Assessment of Overall Global Improvement

IAGI

Improvement from baseline variably defined. Common taxonomy ranges from worse to cleared

4‐pt

7‐pt

Calculated means and standard deviations by assigning zero to 'worse' (or equivalent). Higher scores indicate greater improvement

Investigator's Global Assessment of Disease Severity

IGA

Static equivalent of the IAGI

4‐pt

7‐pt

Calculated means and standard deviations by assigning zero to 'clear' (or equivalent). Higher scores indicate more severe disease

Total Severity Score

TSS

Redness (erythema), thickness (infiltration) and scaling (sometimes also itching (pruritis)) of target plaque(s). Scored separately then summed

0 to 3

0 to 24

Also known as the Local Psoriasis Severity Index or the Total Sum Score. Higher scores indicate more severe disease

Psoriasis Area and Severity Index

PASI

Redness, thickness, and scaliness of the lesions (each graded on a 0 to 4 scale), weighted by the area of involvement (0 to 6) and summed

0 to 68 (without head)

0 to 72 (including head)

Higher scores indicate more severe disease

* Patient's Assessment of Overall Global Improvement

PAGI

Assessed as IAGI

4‐pt

7‐pt

Less often reported than IAGI. Majority of included trials use 5‐pt scale

Patient's Global Assessment of Disease Severity

PGA

Assessed as IGA

4‐pt

5‐pt

Rarely reported (5/177 studies)

* IAGI/PAGI data are entered as a negative values; thus, a reduction denotes a positive improvement for the active treatment consistent with TSS and PASI measures.

Figures and Tables -
Table 2. Overview of outcome measures on effectiveness
Table 3. Summary of imputed standard deviation values

Type of study/score

Placebo

IAGI (change)/IGA (end point)

Placebo

TSS

Placebo

PASI

Placebo

PAGI (change)/PGA (end point)

H2H

IAGI (change)/IGA (end point)

H2H

TSS

H2H

PASI

H2H

PAGI (change)/PGA (end point)

Between‐patient (end point)

0.93

1.33

3.76

1.13

1.01

1.65

3.61

1.12

Within‐patient (end point)

1.08

1.49

7.17

NA

NA

1.50

2.58

NA

Between‐patient (change)

1.17

1.52

5.75

1.31

1.10

1.73

7.85

1.20

Within‐patient (change)

1.02

1.58

NA

1.53

0.96

1.94

NA

0.83

Within‐patient (% change)

NA

0.18

NA

NA

NA

NA

NA

NA

Between‐patient (% change)

NA

NA

0.37

NA

NA

0.13

0.33

NA

Scalp between‐patient (end point)

1.08

1.74

NA

1.06

1.06

1.94

NA

1.18

Scalp within‐patient (end point)

1.33

NA

NA

NA

NA

NA

NA

NA

Scalp between‐patient (change)

1.20

NA

NA

1.28

1.30

1.75

NA

1.20

Scalp between‐patient (% change)

NA

NA

NA

NA

NA

0.25

NA

NA

NA: not available; H2H: head‐to‐head; IGA [PGA]: Investigator [Patient] Global Assessment of Disease Severity;

IAGI [PAGI]: Investigator (patient) Assessment of Global Improvement; TSS: Total Severity Score; PASI: Psoriasis Area and Severity Index

Figures and Tables -
Table 3. Summary of imputed standard deviation values
Table 4. Overview of analyses: evidence of effectiveness outcomes

Comparison No.

Comparison Label

No. studies
(NB: a study may contribute to
more than one comparison)

Per cent studies with
between‐patient design

No.
participants

01

Vitamin D analogues vs. placebo

30

60%

4986

02

Corticosteroid (potent) vs. placebo

13

85%

2216

03

Corticosteroid (very potent) vs. placebo

10

70%

1264

04

Dithranol vs. placebo

3

0%

47

05

Vitamin D combination products vs. placebo

5

100%

2058

06

Other treatment vs. placebo

26

46%

1450

07

Vitamin D analogues vs. corticosteroid (potent)

14

64%

3542

08

Vitamin D analogues vs. corticosteroid (very potent)

2

100%

82

09

Vitamin D combined with corticosteroid vs. corticosteroid

5

100%

2113

10

Vitamin D alone or in combination vs. dithranol

8

88%

1284

11

Vitamin D alone or in combination vs. other vitamin D analogue

4

75%

513

12

Vitamin D alone or in combination vs. vitamin D + corticosteroid

17

94%

5856

13

Vitamin D alone or in combination vs. other treatments: complex regimens

9

89%

2936

14

Vitamin D alone or in combination vs. other treatment: long‐term studies (> 24 wks)

1

100%

297

15

Vitamin D analogues vs. other treatment

19

68%

2364

16

Flexural/facial psoriasis: placebo‐controlled trials

2

100%

122

17

Flexural/facial psoriasis: vitamin D alone or in combination vs. other treatment

4

75%

588

18

Scalp psoriasis: placebo‐controlled trials

14

93%

3011

19

Scalp psoriasis: vitamin D alone or in combination vs. other treatments

12

100%

5413

Figures and Tables -
Table 4. Overview of analyses: evidence of effectiveness outcomes
Table 5. Analysis 01: Trial characteristics and outcomes: vitamin D vs. placebo

Subcategory

Measure

01 IAGI/IGA

02 TSS

03 PASI

04 PAGI/PGA

05 Combined end point

01 Calcipotriol OD/BD

Effect size [CI]

(SMD ‐0.93; 95% CI ‐1.17 to ‐0.68)

(SMD ‐1.15; 95% CI ‐1.41 to ‐0.89)

(SMD ‐0.65; 95% CI ‐0.75 to ‐0.55)

(SMD ‐0.64; 95% CI ‐0.97 to ‐0.30)

(SMD ‐0.96; 95% CI ‐1.15 to ‐0.77)

02 Calcipotriol plus occlusion

Effect size [CI]

NA

(SMD ‐0.15; 95% CI ‐0.44 to 0.14)

(SMD ‐0.15; 95% CI ‐0.44 to 0.14)

03 Calcitriol OD/BD

Effect size [CI]

(SMD ‐1.03; 95% CI ‐1.71 to ‐0.36)

(SMD ‐1.22; 95% CI ‐2.38 to ‐0.07)

(SMD ‐0.59; 95% CI ‐0.76 to ‐0.41)

(SMD ‐0.92; 95% CI ‐1.54 to ‐0.29)

04 Tacalcitol OD

Effect size [CI]

(SMD ‐0.84; 95% CI ‐1.41 to ‐0.26)

(SMD ‐0.66; 95% CI ‐0.95 to ‐0.36)

(SMD ‐0.27; 95% CI ‐0.56 to 0.03)

(SMD ‐0.24; 95% CI ‐0.53 to 0.05)

(SMD ‐0.73; 95% CI ‐1.09 to ‐0.37)

05 Maxacalcitol OD

Effect size [CI]

(SMD ‐1.43; 95% CI ‐1.91 to ‐0.96)

(SMD ‐1.61; 95% CI ‐2.10 to ‐1.12)

(SMD ‐1.43; 95% CI ‐1.91 to ‐0.96)

06 Paricalcitol OD

Effect size [CI]

(SMD ‐1.66; 95% CI ‐2.66 to ‐0.67)

(SMD ‐2.15; 95% CI ‐3.24 to ‐1.06)

(SMD ‐1.66; 95% CI ‐2.66 to ‐0.67)

07 Becocalcidiol OD

Effect size [CI]

(SMD ‐0.22; 95% CI ‐0.58 to 0.14)

(SMD ‐0.02; 95% CI ‐0.37 to 0.34)

(SMD ‐0.22; 95% CI ‐0.58 to 0.14)

08 Becocalcidiol BD

Effect size [CI]

(SMD ‐0.67; 95% CI ‐1.04 to ‐0.30)

(SMD ‐0.46; 95% CI ‐0.83 to ‐0.10)

(SMD ‐0.67; 95% CI ‐1.04 to ‐0.30)

All treatments

Effect size [CI]; I² statistic

(SMD ‐0.95; 95% CI ‐1.17 to ‐0.74):

I² statistic: 89.0%

(SMD ‐1.04; 95% CI ‐1.33 to ‐0.74) I² statistic: 93.0%

(SMD ‐0.58; 95% CI ‐0.71 to ‐0.45):

I² statistic: 42.3%

(SMD ‐0.54; 95% CI ‐0.72 to ‐0.36):

I² statistic: 55.5%

(SMD ‐0.90; 95% CI ‐1.07 to ‐0.72);

I² statistic: 87.5%

No. participants

3771

2647

2357

1467

4986

Between‐patient design

13

9

8

5

18

Within‐patient design

7

10

1

0

12

Treatment duration

4 wks to 12 wks

4 wks to 12 wks

3 wks to 8 wks

8 wks to 8 wks

3 wks to 12 wks

Sensitivity analyses

Within‐patient trials

(SMD ‐1.11; 95% CI ‐1.58 to ‐0.64)

Between‐patient trials

(SMD ‐0.80; 95% CI ‐0.96 to ‐0.63)

Calcitriol, Perez 1996 removed

(SMD ‐0.60; 95% CI ‐0.78 to ‐0.41)

Calcipotriol BD

(SMD ‐1.02; 95% CI ‐1.23 to ‐0.82)

Calcipotriol OD

(SMD ‐0.76; 95% CI ‐1.13 to ‐0.40)

correlation coefficient (rho) = 0

All trials

(SMD ‐0.85; 95% CI ‐1.00 to ‐0.71);
I² statistic: 87.8%

rho = 0

Btw‐patient trials

rho = 0.25

Within‐patient trials

(SMD ‐0.87; 95% CI ‐1.01 to ‐0.72);
I² statistic: 88.8%

rho = 0

Btw‐patient trials

rho = 0.50

Within‐patient trials

(SMD ‐0.88; 95% CI ‐1.03 to ‐0.73);
I² statistic = 90.3%

rho = 0

Btw‐patient trials

rho = 0.75

Within‐patient trials

(SMD ‐0.91; 95% CI ‐1.07 to ‐0.75);
I² statistic: 93.2%

For acronyms, see Table 1.

Figures and Tables -
Table 5. Analysis 01: Trial characteristics and outcomes: vitamin D vs. placebo
Table 6. Analysis 02: Trial characteristics and outcomes: potent steroids vs. placebo

Subcategory

Measure

01 IAGI/IGA

02 TSS

03 PASI

04 PAGI/PGA

05 Combined end point

01 Betamethasone dipropionate OD

Effect size [CI]

(SMD ‐0.81; 95% CI ‐0.98 to ‐0.64)

(SMD ‐0.74; 95% CI ‐1.16 to ‐0.32)

(SMD ‐0.79; 95% CI ‐1.44 to ‐0.14)

(SMD ‐0.80; 95% CI ‐0.96 to ‐0.64)

02 Betamethasone dipropionate BD

Effect size [CI]

(SMD ‐1.35; 95% CI ‐1.56 to ‐1.15)

(SMD ‐0.77; 95% CI ‐1.48 to ‐0.06)

(SMD ‐1.21; 95% CI ‐1.44 to ‐0.97)

(SMD ‐1.35; 95% CI ‐1.56 to ‐1.15)

03 Betamethasone dipropionate, maintenance

Effect size [CI]

(SMD ‐0.95; 95% CI ‐1.62 to ‐0.27)

(SMD ‐0.95; 95% CI ‐1.62 to ‐0.27)

04 Betamethasone valerate

Effect size [CI]

(SMD ‐1.41; 95% CI ‐1.92 to ‐0.90)

(SMD ‐1.09; 95% CI ‐2.00 to ‐0.18)

(SMD ‐1.33; 95% CI ‐1.78 to ‐0.89)

05 Budesonide

Effect size [CI]

06 Desonide

Effect size [CI]

(SMD ‐0.81; 95% CI ‐1.34 to ‐0.28)

(SMD ‐1.16; 95% CI ‐1.70 to ‐0.61)

(SMD ‐0.81; 95% CI ‐1.34 to ‐0.28)

07 Diflorasone diacetate

Effect size [CI]

(SMD ‐0.32; 95% CI ‐0.73 to 0.09)

(SMD ‐0.32; 95% CI ‐0.73 to 0.09)

08 Fluticasone propionate

Effect size [CI]

(SMD ‐0.93; 95% CI ‐1.14 to ‐0.72)

(SMD ‐0.93; 95% CI ‐1.14 to ‐0.72)

09 Hydrocortisone buteprate

Effect size [CI]

(SMD ‐0.46; 95% CI ‐0.77 to ‐0.15)

(SMD ‐0.46; 95% CI ‐0.77 to ‐0.15)

10 Mometasone furoate

Effect size [CI]

(SMD ‐0.75; 95% CI ‐1.17 to ‐0.34)

(SMD ‐1.12; 95% CI ‐1.55 to ‐0.68)

(SMD ‐0.75; 95% CI ‐1.17 to ‐0.34)

All treatments

Effect size [CI]; I² statistic

(SMD ‐1.00; 95% CI ‐1.18 to ‐0.82); I² statistic: 57.6%

(SMD ‐0.77; 95% CI ‐1.01 to ‐0.52); I² statistic: 46.7%

(SMD ‐0.97; 95% CI ‐1.31 to ‐0.62); I² statistic: 79.6%

(SMD ‐0.89; 95% CI ‐1.06 to ‐0.72); I² statistic: 65.1%

No. participants

1867

553

1158

0

2216

Between‐patient design

8

6

3

0

11

Within‐patient design

1

1

0

0

2

Treatment duration

3 wks to 12 wks

2 wks to 12 wks

4 wks to 8 wks

2 wks to 12 wks

Sensitivity analyses

Within‐patient trials

(SMD ‐1.33; 95% CI ‐1.78 to ‐0.89)

Between‐patient trials

(SMD ‐0.85; 95% CI ‐1.03 to ‐0.67)

correlation coefficient (rho) = 0

All trials

(SMD ‐0.89; 95% CI ‐1.06 to ‐0.72) I² statistic: 77.7%

rho = 0

Btw‐patient trials

rho = 0.25

Within‐patient trials

(SMD ‐0.89; 95% CI ‐1.06 to ‐0.72) I² statistic: 78.0%

rho = 0

Btw‐patient trials

rho = 0.50

Within‐patient trials

(SMD ‐0.90; 95% CI ‐1.07 to ‐0.73) I² statistic: 78.6%

rho = 0

Btw‐patient trials

rho = 0.75

Within‐patient trials

(SMD ‐0.91; 95% CI ‐1.08 to ‐0.74) I² statistic: 80.2%

For acronyms, see Table 1. Both within‐patient trials compared betamethasone valerate with placebo.

Figures and Tables -
Table 6. Analysis 02: Trial characteristics and outcomes: potent steroids vs. placebo
Table 7. Analysis 03: Trial characteristics and outcomes: v. potent steroids vs. placebo

Subcategory

Measure

01 IAGI/IGA

02 TSS

03 PASI

04 PAGI/PGA

05 Combined end point

01 Clobetasol propionate

Effect size [CI]

(SMD ‐1.89; 95% CI ‐2.53 to ‐1.24)

(SMD ‐1.35; 95% CI ‐1.80 to ‐0.89)

(SMD ‐1.01; 95% CI ‐1.55 to ‐0.47)

(SMD ‐1.65; 95% CI ‐2.10 to ‐1.20)

02 Halcinonide

Effect size [CI]

03 Halobetasol

Effect size [CI]

(SMD ‐1.81; 95% CI ‐2.37 to ‐1.24)

(SMD ‐1.25; 95% CI ‐1.46 to ‐1.04)

(SMD ‐1.36; 95% CI ‐1.65 to ‐1.07)

All treatments

Effect size [CI], N, I²

(SMD ‐1.87; 95% CI ‐2.38 to ‐1.36); I² statistic: 78.7%

(SMD ‐1.35; 95% CI ‐1.80 to ‐0.89); I² statistic: 75.3%

(SMD ‐1.22; 95% CI ‐1.42 to ‐1.02); I² statistic: 0%

(SMD ‐1.56; 95% CI ‐1.87 to ‐1.26); I² statistic: 81.7%

No. participants

515

545

0

283

1264

Between‐patient design

4

3

0

1

7

Within‐patient design

1

0

0

2

3

Treatment duration

2 wks to 4 wks

2 wks to 4 wks

2 wks to 2 wks

2 wks to 4 wks

Sensitivity analyses

Within‐patient trials

(SMD ‐1.52; 95% CI ‐2.02 to ‐1.02)

Between‐patient trials

(SMD ‐1.58; 95% CI ‐1.99 to ‐1.17)

correlation coefficient (rho) = 0

All trials

(SMD ‐1.52; 95% CI ‐1.80 to ‐1.24) I² statistic: 81.6%

rho = 0

Btw‐patient trials

rho = 0.25

Within‐patient trials

(SMD ‐1.52; 95% CI ‐1.80 to ‐1.25) I² statistic: 82.2%

rho = 0

Btw‐patient trials

rho = 0.50

Within‐patient trials

(SMD ‐1.53; 95% CI ‐1.80 to ‐1.26) I² statistic: 83.3%

rho = 0

Btw‐patient trials

rho = 0.75

Within‐patient trials

(SMD ‐1.55; 95% CI ‐1.80 to ‐1.29) I² statistic: 85.9%

For acronyms, see Table 1.

Figures and Tables -
Table 7. Analysis 03: Trial characteristics and outcomes: v. potent steroids vs. placebo
Table 8. Analysis 05: Trial characteristics and outcomes: vitamin D combination vs. placebo

Subcategory

Measure

01 IAGI/IGA

02 TSS

03 PASI

04 PAGI/PGA

05 Combined end point

01 Combination calcipotriol/betamethasone dipropionate, OD

Effect size [CI]

(SMD ‐1.21; 95% CI ‐1.50 to ‐0.91)

(SMD ‐1.14; 95% CI ‐1.57 to ‐0.70)

(SMD ‐0.69; 95% CI ‐0.98 to ‐0.40)

(SMD ‐1.21; 95% CI ‐1.50 to ‐0.91)

02 Combination calcipotriol/betamethasone dipropionate, BD

Effect size [CI]

(SMD ‐1.90; 95% CI ‐2.09 to ‐1.71)

(SMD ‐1.41; 95% CI ‐1.86 to ‐0.97)

(SMD ‐1.90; 95% CI ‐2.09 to ‐1.71)

All treatments

Effect size [CI], N, I² statistic

(SMD ‐1.44; 95% CI ‐1.76 to ‐1.12); I² statistic: 89.4%

(SMD ‐1.24; 95% CI ‐1.53 to ‐0.95); I² statistic: 87.6%

(SMD ‐0.69; 95% CI ‐0.98 to ‐0.40); I² statistic: NA

(SMD ‐1.44; 95% CI ‐1.76 to ‐1.12); I² statistic: 89.4%

No. participants

2058

0

2056

235

2058

Between‐patient design

5

0

5

1

5

Within‐patient design

0

0

0

0

0

Treatment duration

4 wks to 8 wks

4 wks to 8 wks

8 wks

4 wks to 8 wks

For acronyms, see Table 1.

Figures and Tables -
Table 8. Analysis 05: Trial characteristics and outcomes: vitamin D combination vs. placebo
Table 9. Analysis 06: Trial characteristics and outcomes: other treatments vs. placebo

Subcategory

Measure

01 IAGI/IGA

02 TSS

03 PASI

04 PAGI/PGA

05 Combined end point

01 Aloe vera extract

Effect size [CI]

(SMD ‐1.58; 95% CI ‐2.16 to ‐0.99)

(SMD ‐1.58; 95% CI ‐2.16 to ‐0.99)

02 Anti‐IL‐8 monoclonal antibody cream

Effect size [CI]

(SMD ‐0.59; 95% CI ‐1.01 to ‐0.16)

(SMD ‐0.70; 95% CI ‐1.13 to ‐0.27)

(SMD ‐0.59; 95% CI ‐1.01 to ‐0.16)

03 Betamethasone 17‐valerate 21‐acetate plus tretinoine plus salicylic acid

Effect size [CI]

(SMD ‐0.76; 95% CI ‐1.21 to ‐0.31)

(SMD ‐0.54; 95% CI ‐0.99 to ‐0.10)

(SMD ‐0.80; 95% CI ‐1.26 to ‐0.35)

(SMD ‐0.76; 95% CI ‐1.21 to ‐0.31)

04 Caffeine (topical) 10%, TD

Effect size [CI]

(SMD ‐0.39; 95% CI ‐0.84 to 0.06)

(SMD ‐0.39; 95% CI ‐0.84 to 0.06)

05 Calcipotriene 0.005% ointment + nicotinamide 0.05% or 0.1% or 0.7% or 1.4%, BD

Effect size [CI]

(SMD ‐0.48; 95% CI ‐0.81 to ‐0.15)

(SMD ‐0.48; 95% CI ‐0.81 to ‐0.15)

06 Dead sea salts emollient lotion

Effect size [CI]

(SMD 0.57; 95% CI ‐0.36 to 1.51)

(SMD 0.57; 95% CI ‐0.36 to 1.51)

07 Fish oil plus occlusion

Effect size [CI]

(SMD ‐1.05; 95% CI ‐1.64 to ‐0.46)

(SMD ‐1.05; 95% CI ‐1.64 to ‐0.46)

08 Herbal skin care (Dr Michaels® cleansing gel, ointment and skin conditioner), BD

Effect size [CI]

(SMD ‐2.96; 95% CI ‐4.19 to ‐1.74)

(SMD ‐2.96; 95% CI ‐4.19 to ‐1.74)

09 Hexafluoro‐1,25‐dihydroxyvitamin D3

Effect size [CI]

(SMD ‐0.62; 95% CI ‐1.35 to 0.12)

(SMD ‐1.13; 95% CI ‐1.91 to ‐0.35)

(SMD ‐0.62; 95% CI ‐1.35 to 0.12)

10 Indigo naturalis 1.4% ointment

Effect size [CI]

(SMD ‐2.14; 95% CI ‐2.74 to ‐1.53)

(SMD ‐1.64; 95% CI ‐2.13 to ‐1.15)

(SMD ‐2.09; 95% CI ‐2.62 to ‐1.56)

11 Kukui nut oil, TD

Effect size [CI]

(SMD 0.00; 95% CI ‐0.80 to 0.80)

(SMD 0.33; 95% CI ‐0.48 to 1.14)

(SMD ‐0.03; 95% CI ‐0.84 to 0.77)

(SMD 0.00; 95% CI ‐0.80 to 0.80)

(SMD 0.00; 95% CI ‐0.80 to 0.80)

12 Mahonia aquifolium (Reliéva™), BD

Effect size [CI]

(SMD ‐0.77; 95% CI ‐1.06 to ‐0.48)

13 Methotrexate gel

Effect size [CI]

(SMD ‐0.56; 95% CI ‐1.01 to ‐0.12)

(SMD ‐0.48; 95% CI ‐0.92 to ‐0.04)

(SMD ‐1.58; 95% CI ‐2.16 to ‐0.99)

(SMD ‐1.05; 95% CI ‐2.04 to ‐0.06)

14 Mycophenolic acid ointment

Effect size [CI]

(SMD ‐1.44; 95% CI ‐2.67 to ‐0.22)

(SMD ‐1.44; 95% CI ‐2.67 to ‐0.22)

15 NG‐monomethyl‐L‐arginine (L‐NMMA) cream

Effect size [CI]

(SMD 0.08; 95% CI ‐0.60 to 0.75)

(SMD 0.08; 95% CI ‐0.60 to 0.75)

16 Nicotinamide 1.4%, BD

Effect size [CI]

(SMD ‐0.20; 95% CI ‐0.60 to 0.20)

(SMD ‐0.20; 95% CI ‐0.60 to 0.20)

17 Oleum horwathiensis

Effect size [CI]

(SMD ‐0.02; 95% CI ‐0.63 to 0.58)

(SMD ‐0.77; 95% CI ‐1.40 to ‐0.14)

(SMD ‐0.02; 95% CI ‐0.63 to 0.58)

18 Omega‐3‐polyunsaturated fatty acids ointment

Effect size [CI]

19 Platelet aggregation activating factor (PAF) (Ro 24‐0238)

Effect size [CI]

(SMD ‐0.07; 95% CI ‐0.50 to 0.37)

(SMD ‐0.07; 95% CI ‐0.50 to 0.37)

20 Polymyxin B cream, 200,000 U/g

Effect size [CI]

(SMD 0.13; 95% CI ‐0.59 to 0.85)

(SMD 0.13; 95% CI ‐0.59 to 0.85)

21 PTH (1‐34) in Novasome A® liposomal cream, BD

Effect size [CI]

(SMD ‐2.31; 95% CI ‐3.26 to ‐1.36)

(SMD ‐2.31; 95% CI ‐3.26 to ‐1.36)

22 Sirolimus (topical), 2.2% for 6 wks, then 8% for a further 6 wks

Effect size [CI]

(SMD ‐0.39; 95% CI ‐0.98 to 0.21)

(SMD ‐0.39; 95% CI ‐0.98 to 0.21)

23 Tacrolimus ointment

Effect size [CI]

(SMD 0.06; 95% CI ‐0.52 to 0.63)

(SMD 0.06; 95% CI ‐0.52 to 0.63)

24 Tar

Effect size [CI]

(SMD ‐0.45; 95% CI ‐1.11 to 0.22)

(SMD ‐0.45; 95% CI ‐1.11 to 0.22)

25 Tazarotene

Effect size [CI]

(SMD ‐0.86; 95% CI ‐1.11 to ‐0.62)

(SMD ‐0.86; 95% CI ‐1.11 to ‐0.62)

26 Theophylline 1% ointment, BD

Effect size [CI]

(SMD ‐2.87; 95% CI ‐4.13 to ‐1.62)

(SMD ‐2.87; 95% CI ‐4.13 to ‐1.62)

All treatments

(not pooled)

No. participants

364

907

529

105

1450

Between‐patient design

4

5

8

2

12

Within‐patient design

4

12

1

0

14

Treatment duration

3 wks to 12 wks

3 wks to 12 wks

2 wks to 12 wks

3 wks to 12 wks

2 wks to 12 wks

For acronyms, see Table 1.

Figures and Tables -
Table 9. Analysis 06: Trial characteristics and outcomes: other treatments vs. placebo
Table 10. Analysis 07: Trial characteristics and outcomes: vitamin D vs. potent steroids

Subcategory

Measure

01 IAGI/IGA

02 TSS

03 PASI

04 PAGI/PGA

05 Combined end point

01 Calcipotriol vs. betamethasone dipropionate

Effect size [CI]

(SMD 0.43; 95% CI 0.28 to 0.58)

(SMD 0.36; 95% CI 0.22 to 0.51)

(SMD 0.43; 95% CI 0.28 to 0.58)

02 Calcipotriol vs. betamethasone valerate

Effect size [CI]

(SMD ‐0.02; 95% CI ‐0.21 to 0.17)

(SMD ‐0.26; 95% CI ‐0.41 to ‐0.11)

(SMD ‐0.12; 95% CI ‐0.22 to ‐0.02)

(SMD ‐0.26; 95% CI ‐0.38 to ‐0.14)

(SMD ‐0.12; 95% CI ‐0.26 to 0.02)

03 Calcipotriol vs. desoxymetasone

Effect size [CI]

(SMD 0.15; 95% CI ‐0.73 to 1.02)

(SMD 0.15; 95% CI ‐0.73 to 1.02)

04 Calcipotriol vs. diflorasone diacetate

Effect size [CI]

(SMD 0.27; 95% CI 0.02 to 0.52)

(SMD 0.40; 95% CI 0.15 to 0.65)

(SMD 0.27; 95% CI 0.02 to 0.52)

05 Calcipotriol vs. fluocinonide

Effect size [CI]

(SMD ‐0.58; 95% CI ‐0.99 to ‐0.18)

(SMD ‐0.50; 95% CI ‐0.92 to ‐0.07)

(SMD ‐0.58; 95% CI ‐0.99 to ‐0.18)

06 Calcitriol vs. betamethasone dipropionate

Effect size [CI]

(SMD 0.21; 95% CI ‐0.04 to 0.45)

(SMD 0.27; 95% CI 0.02 to 0.51)

(SMD 0.39; 95% CI 0.14 to 0.63)

(SMD 0.21; 95% CI ‐0.04 to 0.45)

07 Calcitriol vs. betamethasone valerate

Effect size [CI]

(SMD ‐0.19; 95% CI ‐0.91 to 0.53)

(SMD ‐0.19; 95% CI ‐0.91 to 0.53)

08 Tacalcitol vs. betamethasone valerate

Effect size [CI]

(SMD 0.41; 95% CI 0.09 to 0.74)

(SMD 0.41; 95% CI 0.09 to 0.74)

All treatments

Effect size [CI]; I² statistic

(SMD 0.17; 95% CI ‐0.04 to 0.37); I² statistic: 83.4%

(SMD 0.11; 95% CI ‐0.22 to 0.44); I² statistic: 86.7%

(SMD 0.12; 95% CI ‐0.07 to 0.32); I² statistic: 86.2%

(SMD ‐0.26; 95% CI ‐0.38 to ‐0.14); I² statistic: 0%

(SMD 0.11; 95% CI ‐0.07 to 0.30); I² statistic: 85.6%

No. participants

2655

891

3185

738

3542

Between‐patient design

7

2

7

1

9

Within‐patient design

1

4

2

1

5

Treatment duration

3 wks to 8 wks

3 wks to 6 wks

4 wks to 8 wks

6 wks

3 wks to 8 wks

Sensitivity analyses

Within‐patient trials

(SMD 0.17; 95% CI ‐0.20 to 0.54)

Between‐patient trials

(SMD 0.10; 95% CI ‐0.11 to 0.31)

correlation coefficient (rho) = 0

All trials

(SMD 0.10; 95% CI ‐0.08 to 0.28);
I² statistic: 90.5%

rho = 0

Btw‐patient trials

rho = 0.25

Within‐patient trials

(SMD 0.10; 95% CI ‐0.07 to 0.28)
I² statistic: 91.3%

rho = 0

Btw‐patient trials

rho = 0.50

Within‐patient trials

(SMD 0.11; 95% CI ‐0.07 to 0.29)
I² statistic: 92.4%

rho = 0

Btw‐patient trials

rho = 0.75

Within‐patient trials

(SMD 0.12; 95% CI ‐0.06 to 0.30)
I² statistic: 94.3%

For acronyms, see Table 1.

Figures and Tables -
Table 10. Analysis 07: Trial characteristics and outcomes: vitamin D vs. potent steroids
Table 11. Analysis 08: Trial characteristics and outcomes: vitamin D vs. v. potent steroids

Subcategory

Measure

01 IAGI/IGA

02 TSS

03 PASI

04 PAGI/PGA

05 Combined end point

01 Calcipotriol vs. clobetasol propionate

Effect size [CI]

(SMD 0.19; 95% CI ‐0.42 to 0.80)

(SMD ‐0.32; 95% CI ‐0.95 to 0.30)

(SMD 0.42; 95% CI ‐0.20 to 1.03)

(SMD ‐0.06; 95% CI ‐0.57 to 0.44); I² statistic: 25.7%

All treatments

No. participants

42

0

40

42

82

Between‐patient design

1

0

1

1

2

Within‐patient design

0

0

0

0

0

Treatment duration

2 wks

6 wks

2 wks

2 wks to 6 wks

Figures and Tables -
Table 11. Analysis 08: Trial characteristics and outcomes: vitamin D vs. v. potent steroids
Table 12. Analysis 09: Trial characteristics and outcomes: vitamin D + steroid vs. steroid

Subcategory

Measure

01 IAGI/IGA

02 TSS

03 PASI

04 PAGI/PGA

05 Combined end point

01 Calcipotriol + betamethasone dipropionate vs. betamethasone dipropionate

Effect size [CI]

(SMD ‐0.40; 95% CI ‐0.52 to ‐0.27)

(SMD ‐0.44; 95% CI ‐0.55 to ‐0.33)

(SMD ‐0.40; 95% CI ‐0.52 to ‐0.27)

02 Calcipotriol + betamethasone dipropionate vs. clobetasol propionate

Effect size [CI]

(SMD 0.45; 95% CI 0.09 to 0.81)

(SMD 0.45; 95% CI 0.09 to 0.81)

03 Calcipotriol + clobetasol propionate vs. clobetasol propionate

Effect size [CI]

(SMD ‐0.69; 95% CI ‐1.22 to ‐0.15)

(SMD ‐0.28; 95% CI ‐0.80 to 0.24)

(SMD ‐0.69; 95% CI ‐1.22 to ‐0.15)

Effect size [CI], I²

(SMD ‐0.41; 95% CI ‐0.53 to ‐0.29); I² statistic: 32.0%

(SMD 0.45; 95% CI 0.09 to 0.81): I² statistic: NA

(SMD ‐0.44; 95% CI ‐0.55 to ‐0.33) I² statistic: 22.4%

(SMD ‐0.28; 95% CI ‐0.80 to 0.24) I² statistic: NA

(SMD ‐0.26; 95% CI ‐0.52 to ‐0.00); I² statistic: 84.4%

No. participants

1991

122

1876

65

2113

Between‐patient design

4

1

3

1

5

Within‐patient design

0

0

0

0

0

Treatment duration

2 wks to 8 wks

4 wks

4 wks to 8 wks

2 wks

2 wks to 8 wks

Figures and Tables -
Table 12. Analysis 09: Trial characteristics and outcomes: vitamin D + steroid vs. steroid
Table 13. Analysis 10: Trial characteristics and outcomes: vitamin D vs. dithranol

Subcategory

Measure

01 IAGI/IGA

02 TSS

03 PASI

04 PAGI/PGA

05 Combined end point

01 Calcipotriol vs. dithranol

Effect size [CI]

(SMD ‐0.43; 95% CI ‐0.85 to ‐0.01)

(SMD ‐0.54; 95% CI ‐1.16 to 0.08)

(SMD 0.73; 95% CI ‐0.55 to 2.00)

(SMD ‐0.05; 95% CI ‐0.90 to 0.80)

(SMD 0.07; 95% CI ‐0.57 to 0.71)

02 Calcitriol vs. dithranol

Effect size [CI]

(SMD 0.51; 95% CI 0.13 to 0.88)

(SMD 0.13; 95% CI ‐0.24 to 0.50)

(SMD ‐0.21; 95% CI ‐0.58 to 0.16)

(SMD 0.51; 95% CI 0.13 to 0.88)

03 Tacalcitol vs. dithranol

Effect size [CI]

(SMD ‐0.18; 95% CI ‐0.60 to 0.25)

(SMD ‐0.07; 95% CI ‐0.50 to 0.36)

(SMD ‐0.18; 95% CI ‐0.60 to 0.25)

All treatments

Effect size [CI], I² statistic

(SMD ‐0.24; 95% CI ‐0.72 to 0.25); I² statistic:93.0%

(SMD ‐0.27; 95% CI ‐0.73 to 0.20); I² statistic: 80.6%

(SMD 0.36; 95% CI ‐0.33 to 1.04); I² statistic: 94.5%

(SMD ‐0.05; 95% CI ‐0.90 to 0.80); I² statistic: 92.5%

(SMD 0.09; 95% CI ‐0.44 to 0.63); I² statistic: 94.9%

No. participants

1108

386

796

544

1284

Between‐patient design

5

3

5

2

7

Within‐patient design

0

1

0

0

1

Treatment duration

8 wks to 12 wks

4 wks to 8 wks

8 wks to 12 wks

8 wks to 12 wks

4 wks to 12 wks

Figures and Tables -
Table 13. Analysis 10: Trial characteristics and outcomes: vitamin D vs. dithranol
Table 14. Analysis 11: Trial characteristics and outcomes: vitamin D vs. vitamin D

Subcategory

Measure

01 IAGI/IGA

02 TSS

03 PASI

04 PAGI/PGA

05 Combined end point

01 Calcipotriol vs. calcitriol

Effect size [CI]

(SMD 0.00; 95% CI ‐0.25 to 0.25)

(SMD ‐0.32; 95% CI ‐0.57 to ‐0.07)

(SMD ‐1.11; 95% CI ‐2.22 to 0.01)

(SMD 0.04; 95% CI ‐0.21 to 0.29)

(SMD ‐0.41; 95% CI ‐1.46 to 0.64)

02 Calcipotriol vs. tacalcitol

Effect size [CI]

(SMD ‐0.47; 95% CI ‐0.73 to ‐0.21)

(SMD ‐0.45; 95% CI ‐0.68 to ‐0.22)

(SMD ‐0.47; 95% CI ‐0.73 to ‐0.21)

03 Calcipotriol vs. maxacalcitol

Effect size [CI]

(SMD 0.43; 95% CI ‐0.12 to 0.98)

(SMD 0.13; 95% CI ‐0.41 to 0.68)

(SMD 0.43; 95% CI ‐0.12 to 0.98)

All treatments

Effect size [CI], I²

(SMD ‐0.06; 95% CI ‐0.51 to 0.38); I² statistic: 82.2%

(SMD ‐0.31; 95% CI ‐0.55 to ‐0.06); I² statistic: 46.9%

(SMD ‐1.11; 95% CI ‐2.22 to 0.01); I² statistic: NA

(SMD 0.04; 95% CI ‐0.21 to 0.29); I² statistic: NA

(SMD ‐0.17; 95% CI ‐0.62 to 0.27); I² statistic: 78.5%

No. participants

498

563

15

250

513

Between‐patient design

2

2

1

1

3

Within‐patient design

1

1

0

0

1

Treatment duration

8 wks to 12 wks

8 wks to 12 wks

8 wks

12 wks

8 wks to 12 wks

Sensitivity analyses

TSS data from Ji 2008 used in combined end point:

01 Calcipotriol vs. calcitriol

(SMD ‐0.52; 95% CI ‐1.19 to 0.15; I² statistic: 44.9%)

TSS data from Ji 2008 used in combined end point:

all treatments

(SMD ‐0.28; 95% CI ‐0.66 to 0.10; I² statistic: 70.6%)

Figures and Tables -
Table 14. Analysis 11: Trial characteristics and outcomes: vitamin D vs. vitamin D
Table 15. Analysis 12: Trial characteristics and outcomes: vitamin D vs. vitamin D + steroid

Subcategory

Measure

01 IAGI/IGA

02 TSS

03 PASI

04 PAGI/PGA

05 Combined end point

01 Calcipotriol BD vs. calcipotriol OM, BMD ON

Effect size [CI]

(SMD 0.56; 95% CI 0.23 to 0.88)

(SMD 0.46; 95% CI 0.10 to 0.82)

(SMD 0.56; 95% CI 0.23 to 0.88)

02 Calcipotriol OD vs. combined calcipotriol + BMD OD

Effect size [CI]

(SMD 0.66; 95% CI 0.31 to 1.02)

(SMD 0.67; 95% CI 0.23 to 1.11)

(SMD 0.66; 95% CI 0.31 to 1.02)

03 Calcipotriol BD vs. combined calcipotriol + BMD OD

Effect size [CI]

(SMD 0.27; 95% CI 0.06 to 0.48)

(SMD 0.25; 95% CI 0.03 to 0.48)

(SMD 0.52; 95% CI 0.38 to 0.67)

(SMD 0.43; 95% CI 0.20 to 0.66)

04 Calcipotriol BD vs. combined calcipotriol + BMD BD

Effect size [CI]

(SMD 0.66; 95% CI 0.40 to 0.93)

(SMD 0.64; 95% CI 0.46 to 0.83)

(SMD 0.66; 95% CI 0.40 to 0.93)

05 Calcipotriol BD vs. calcipotriol OM, BMV ON

Effect size [CI]

(SMD 0.27; 95% CI ‐0.19 to 0.74)

(SMD 0.43; 95% CI ‐0.07 to 0.93)

(SMD 0.27; 95% CI ‐0.19 to 0.74)

06 Calcipotriol BD vs. calcipotriol OM, clobetasone butyrate ON

Effect size [CI]

(SMD 0.27; 95% CI 0.05 to 0.48)

(SMD 0.17; 95% CI ‐0.04 to 0.38)

(SMD 0.27; 95% CI 0.05 to 0.48)

07 Calcipotriol BD vs. calcipotriol BD + clobetasol propionate BD

Effect size [CI]

(SMD 0.88; 95% CI 0.34 to 1.42)

(SMD 0.70; 95% CI 0.16 to 1.23)

(SMD 0.88; 95% CI 0.34 to 1.42)

08 Calcipotriol BD vs. calcipotriol OM, diflucortolone valerate ON

Effect size [CI]

(SMD 0.08; 95% CI ‐0.29 to 0.44)

(SMD 0.08; 95% CI ‐0.29 to 0.44)

09 Calcipotriol OD vs. calcipotriol OM, fluocinonide acetonide ON

Effect size [CI]

(SMD 0.53; 95% CI ‐0.11 to 1.18)

(SMD 0.53; 95% CI ‐0.11 to 1.18)

10 Calcipotriol OD vs. combined calcipotriol + hydrocortisone OD

Effect size [CI]

(SMD 0.14; 95% CI ‐0.06 to 0.33)

(SMD 0.08; 95% CI ‐0.11 to 0.28)

(SMD 0.14; 95% CI ‐0.06 to 0.33)

11 calcitriol BD vs. diflucortolone valerate OM, calcitriol ON

Effect size [CI]

(SMD 0.24; 95% CI ‐0.09 to 0.57)

(SMD 0.24; 95% CI ‐0.09 to 0.57)

12 Tacalcitol OD vs. combined calcipotriol + BMD OD

Effect size [CI]

(SMD 0.48; 95% CI 0.26 to 0.70)

(SMD 0.47; 95% CI 0.25 to 0.69)

(SMD 0.46; 95% CI 0.24 to 0.68)

(SMD 0.48; 95% CI 0.26 to 0.70)

All treatments

Effect size [CI], I² statistic

(SMD 0.48; 95% CI 0.32 to 0.65), I² statistic: 86.9%

(SMD 0.25; 95% CI 0.03 to 0.48)

(SMD 0.47; 95% CI 0.34 to 0.59), I² statistic: 82.3%

(SMD 0.49; 95% CI 0.29 to 0.69), I² statistic: 0%

(SMD 0.46; 95% CI 0.33 to 0.59), I² statistic: 83.3%

No. participants

4791

301

5703

399

5856

Between‐patient design

11

1

15

2

16

Within‐patient design

0

0

1

0

1

Treatment duration

2 wks to 8 wks

4 wks

2 wks to 12 wks

2 wks to 8 wks

2 wks to 12 wks

For acronyms, see Table 1.

Figures and Tables -
Table 15. Analysis 12: Trial characteristics and outcomes: vitamin D vs. vitamin D + steroid
Table 16. Analysis 13: Trial characteristics and outcomes: vitamin D vs. other treatments: complex regimens

Subcategory

Measure

01 IAGI/IGA

02 TSS

03 PASI

04 PAGI/PGA

05 Combined end point

01 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (8 wks); then calcipotriol (4 wks)

Effect size [CI]

(SMD ‐0.12; 95% CI ‐0.29 to 0.04)

(SMD ‐0.04; 95% CI ‐0.19 to 0.11)

(SMD ‐0.14; 95% CI ‐0.30 to 0.02)

(SMD ‐0.12; 95% CI ‐0.29 to 0.04)

02 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (8 wks)

Effect size [CI]

(SMD 0.29; 95% CI ‐0.04 to 0.62)

(SMD 0.29; 95% CI ‐0.04 to 0.62)

03 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) & combined calcipotriol + BMD (w/e) (8 wks)

Effect size [CI]

(SMD 0.13; 95% CI ‐0.04 to 0.29)

(SMD 0.10; 95% CI ‐0.05 to 0.25)

(SMD 0.10; 95% CI ‐0.06 to 0.26)

(SMD 0.13; 95% CI ‐0.04 to 0.29)

04 Calcipotriol (6 wks) vs. clobetasol propionate (2 wks); then calcipotriol (4 wks)

Effect size [CI]

(SMD 0.60; 95% CI 0.18 to 1.02)

(SMD 0.63; 95% CI 0.21 to 1.05)

(SMD 0.60; 95% CI 0.18 to 1.02)

05 Calcipotriol (6 wks) vs. calcipotriol OM, fluocinonide acetonide ON (2 wks); then calcipotriol BD (4 wks)

Effect size [CI]

(SMD 0.66; 95% CI 0.01 to 1.32)

(SMD 0.66; 95% CI 0.01 to 1.32)

06 Calcipotriol (6 wks) vs. halometasone OM, calcipotriol ON (2 wks); then calcipotriol BD (w/dy), halometasone (w/e) (2 wks); then calcipotriol BD (2wks)

Effect size [CI]

(SMD 0.41; 95% CI ‐0.05 to 0.86)

(SMD 1.13; 95% CI 0.64 to 1.62)

(SMD 0.41; 95% CI ‐0.05 to 0.86)

07 Calcipotriol ON, clobetasol propionate OM (2 to 4 wks); then calcipotriol BD (to wk12) vs. calcitriol ON, clobetasol propionate OM (2 to 4 wks); then calcitriol BD (to wk12)

Effect size [CI]

(SMD ‐0.19; 95% CI ‐0.54 to 0.16)

(SMD ‐0.27; 95% CI ‐0.62 to 0.09)

(SMD ‐0.19; 95% CI ‐0.54 to 0.16)

08 Combined calcipotriol + BMD (4 wks); then placebo ointment BD (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol ointment BD (8 wks)

Effect size [CI]

(SMD 0.27; 95% CI 0.12 to 0.41)

(SMD 0.25; 95% CI 0.10 to 0.39)

(SMD 0.28; 95% CI 0.13 to 0.42)

(SMD 0.27; 95% CI 0.12 to 0.41)

09 Combined calcipotriol + BMD (4 wks); then placebo ointment BD (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy)+ combined calcipotriol + BMD (w/e) (8 wks)

Effect size [CI]

(SMD 0.51; 95% CI 0.37 to 0.66)

(SMD 0.59; 95% CI 0.45 to 0.74)

(SMD 0.71; 95% CI 0.56 to 0.85)

(SMD 0.51; 95% CI 0.37 to 0.66)

10 combined calcipotriol + BMD (4 wks); then calcipotriol ointment BD (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) + combined calcipotriol + BMD (w/e) (8 wks)

Effect size [CI]

(SMD 0.26; 95% CI 0.11 to 0.40)

(SMD 0.30; 95% CI 0.16 to 0.45)

(SMD 0.44; 95% CI 0.29 to 0.58)

(SMD 0.26; 95% CI 0.11 to 0.40)

11 Combined calcipotriol + BMD (8 wks); then calcipotriol (4 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) & combined calcipotriol + BMD (w/e) (8 wks)

Effect size [CI]

(SMD 0.24; 95% CI 0.08 to 0.40)

(SMD 0.15; 95% CI ‐0.01 to 0.30)

(SMD 0.23; 95% CI 0.07 to 0.39)

(SMD 0.24; 95% CI 0.08 to 0.40)

12 Tacalcitol (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks)

Effect size [CI]

(SMD 0.54; 95% CI 0.36 to 0.72)

(SMD 0.49; 95% CI 0.31 to 0.67)

(SMD 0.54; 95% CI 0.36 to 0.72)

(SMD 0.54; 95% CI 0.36 to 0.72)

All treatments

(not pooled)

No. participants

2755

46

2991

2508

2936

Between‐patient design

6

0

8

4

8

Within‐patient design

1

1

0

0

1

Treatment duration

6 wks to 12 wks

6 wks

2 wks to 12 wks

8 wks to 12 wks

2 wks to 12 wks

For acronyms, see Table 1.

Figures and Tables -
Table 16. Analysis 13: Trial characteristics and outcomes: vitamin D vs. other treatments: complex regimens
Table 17. Analysis 14: Trial characteristics and outcomes: vitamin D vs. other treatment: long‐term studies (> 24 wks)

Subcategory

Measure

01 IAGI/IGA

02 TSS

03 PASI

04 PAGI/PGA

05 Combined end point

01 Combined calcipotriol + BMD (52 wks) vs. alternating: combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks)

Effect size [CI]

(SMD ‐0.09; 95% CI ‐0.36 to 0.18)

(SMD ‐0.09; 95% CI ‐0.36 to 0.18)

02 Combined calcipotriol+BMD (52 wks) vs. combined calcipotriol+ BMD (4 wks); then calcipotriol (48 wks)

Effect size [CI]

(SMD ‐0.18; 95% CI ‐0.47 to 0.10)

(SMD ‐0.18; 95% CI ‐0.47 to 0.10)

03 Alternating: combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (48 wks)

Effect size [CI]

(SMD ‐0.09; 95% CI ‐0.37 to 0.19)

(SMD ‐0.09; 95% CI ‐0.37 to 0.19)

All treatments

(no pooling)

No. participants

297

0

0

0

297

Between‐patient design

1

0

0

0

1

Within‐patient design

0

0

0

0

0

Treatment duration

52 wks

52 wks

For acronyms, see Table 1.

Figures and Tables -
Table 17. Analysis 14: Trial characteristics and outcomes: vitamin D vs. other treatment: long‐term studies (> 24 wks)
Table 18. Analysis 15: Trial characteristics and outcomes: vitamin D/other treatment

Subcategory

Measure

01 IAGI/IGA

02 TSS

03 PASI

04 PAGI/PGA

05 Combined end point

01 Calcipotriol vs. coal tar

Effect size [CI]

(SMD ‐0.53; 95% CI ‐1.74 to 0.68)

(SMD ‐0.10; 95% CI ‐1.54 to 1.35)

(SMD ‐0.10; 95% CI ‐1.54 to 1.35)

(SMD ‐0.53; 95% CI ‐1.74 to 0.68)

02 Calcipotriol vs. coal tar polytherapy

Effect size [CI]

(SMD ‐0.59; 95% CI ‐0.87 to ‐0.31)

(SMD ‐0.51; 95% CI ‐0.86 to ‐0.16)

(SMD ‐0.63; 95% CI ‐1.06 to ‐0.20)

(SMD ‐0.63; 95% CI ‐1.06 to ‐0.20)

(SMD ‐0.59; 95% CI ‐0.87 to ‐0.31)

03 Calcipotriol vs. nicotinamide 1.4%, BD

Effect size [CI]

(SMD ‐0.09; 95% CI ‐0.49 to 0.31)

(SMD ‐0.09; 95% CI ‐0.49 to 0.31)

04 Calcipotriol vs. calcipotriol + nicotinamide 1.4%, BD

Effect size [CI]

(SMD 0.19; 95% CI ‐0.14 to 0.52)

(SMD 0.19; 95% CI ‐0.14 to 0.52)

05 Calcipotriol vs. corticosteroid + salicylic acid

Effect size [CI]

(SMD ‐0.06; 95% CI ‐0.33 to 0.22)

(SMD ‐0.05; 95% CI ‐0.36 to 0.26)

(SMD ‐0.49; 95% CI ‐0.79 to ‐0.20)

(SMD ‐0.05; 95% CI ‐0.26 to 0.15)

06 Calcipotriol vs. propylthiouracil cream

Effect size [CI]

(SMD ‐2.24; 95% CI ‐3.23 to ‐1.25)

(SMD ‐2.24; 95% CI ‐3.23 to ‐1.25)

07 Calcipotriol vs. tacrolimus ointment

Effect size [CI]

(SMD ‐0.35; 95% CI ‐1.51 to 0.81)

(SMD ‐0.13; 95% CI ‐0.51 to 0.24)

(SMD ‐0.55; 95% CI ‐1.28 to 0.17)

08 Calcipotriol vs. tazarotene

Effect size [CI]

(SMD ‐0.22; 95% CI ‐0.60 to 0.16)

(SMD ‐0.05; 95% CI ‐0.33 to 0.23)

(SMD ‐0.35; 95% CI ‐0.99 to 0.29)

(SMD ‐0.10; 95% CI ‐0.35 to 0.16)

09 Calcipotriol vs. tazarotene gel plus mometasone furoate cream

Effect size [CI]

10 Calcipotriol vs. vitamin B12 cream

Effect size [CI]

(SMD ‐0.55; 95% CI ‐1.33 to 0.24)

(SMD ‐0.01; 95% CI ‐0.78 to 0.75)

(SMD ‐0.55; 95% CI ‐1.33 to 0.24)

(SMD ‐0.55; 95% CI ‐1.33 to 0.24)

11 Head‐to‐head vitamin D alone or in combination: dosing

Effect size [CI]

(SMD ‐0.24; 95% CI ‐0.38 to ‐0.09)

(SMD ‐0.12; 95% CI ‐0.25 to 0.00)

(SMD ‐0.20; 95% CI ‐0.32 to ‐0.07)

12 Head‐to‐head vitamin D alone or in combination: occlusion

Effect size [CI]

(SMD ‐0.18; 95% CI ‐2.04 to 1.68)

(SMD ‐0.18; 95% CI ‐2.04 to 1.68)

All treatments

(not pooled)

No. participants

1386

898

1228

456

2364

Between‐patient design

8

5

6

3

13

Within‐patient design

2

2

3

3

6

Treatment duration

4 wks to 12 wks

6 wks to 12 wks

4 wks to 12 wks

4 wks to 12 wks

4 wks to 12 wks

For acronyms, see Table 1.

Figures and Tables -
Table 18. Analysis 15: Trial characteristics and outcomes: vitamin D/other treatment
Table 19. Analysis 16: Trial characteristics and outcomes: flexural/facial psoriasis: placebo trials

Subcategory

Measure

01 IAGI/IGA

02 TSS

03 PASI

04 PAGI/PGA

05 Combined end point

01 Betamethasone valerate 0.1%, OD

Effect size [CI]

(SMD ‐2.83; 95% CI ‐3.79 to ‐1.88)

(SMD ‐2.83; 95% CI ‐3.79 to ‐1.88)

02 Calcipotriol ointment, OD

Effect size [CI]

(SMD ‐1.08; 95% CI ‐1.77 to ‐0.40)

(SMD ‐1.08; 95% CI ‐1.77 to ‐0.40)

03 Pimecrolimus cream, 1% OD/BD

Effect size [CI]

(SMD ‐1.07; 95% CI ‐1.69 to ‐0.45)

(SMD ‐1.37; 95% CI ‐1.95 to ‐0.79)

(SMD ‐0.62; 95% CI ‐1.27 to 0.02)

(SMD ‐0.65; 95% CI ‐1.24 to ‐0.06)

(SMD ‐0.86; 95% CI ‐1.30 to ‐0.41)

04 Tacrolimus ointment 0.1%, BD

Effect size [CI]

All treatments

(no pooling)

No. participants

47

57

75

47

122

Between‐patient design

1

1

1

1

2

Within‐patient design

0

0

0

0

0

Treatment duration

8 wks

8 wks

4 wks

8 wks

4 wks to 8 wks

For acronyms, see Table 1.

Figures and Tables -
Table 19. Analysis 16: Trial characteristics and outcomes: flexural/facial psoriasis: placebo trials
Table 20. Analysis 17: Trial characteristics and outcomes: flexural/facial psoriasis: vitamin D vs. other treatment

Subcategory

Measure

01 IAGI/IGA

02 TSS

03 PASI

04 PAGI/PGA

05 Combined end point

01 Calcipotriol vs. BMV

Effect size [CI]

(SMD 2.02; 95% CI 1.20 to 2.84)

(SMD 2.02; 95% CI 1.20 to 2.84)

02 Calcipotriol vs. calcipotriol + hydrocortisone

Effect size [CI]

(SMD 0.30; 95% CI 0.11 to 0.50)

(SMD 0.32; 95% CI 0.12 to 0.51)

(SMD 0.30; 95% CI 0.11 to 0.50)

03 Calcipotriol vs. calcitriol

Effect size [CI]

(SMD 0.61; 95% CI 0.28 to 0.94)

(SMD 0.61; 95% CI 0.28 to 0.94)

04 Calcipotriol vs. pimecrolimus

Effect size [CI]

(SMD ‐0.53; 95% CI ‐1.17 to 0.11)

(SMD ‐0.53; 95% CI ‐1.17 to 0.11)

05 Calcitriol vs. tacrolimus

Effect size [CI]

(SMD 0.42; 95% CI ‐0.15 to 0.98)

(SMD 0.29; 95% CI ‐0.27 to 0.85)

(SMD 0.42; 95% CI ‐0.15 to 0.98)

All treatments

(no pooling)

No. participants

457

124

464

0

588

Between‐patient design

2

1

2

0

3

Within‐patient design

0

1

0

0

1

Treatment duration

6 wks to 8 wks

6 wks

4 wks to 8 wks

0

4 wks to 8 wks

For acronyms, see Table 1.

Figures and Tables -
Table 20. Analysis 17: Trial characteristics and outcomes: flexural/facial psoriasis: vitamin D vs. other treatment
Table 21. Analysis 18: Trial characteristics and outcomes: scalp psoriasis: placebo‐controlled trials

Subcategory

Measure

01 IAGI/IGA

02 TSS

03 PASI

04 PAGI/PGA

05 Combined end point

01 Vitamin D: calcipotriol

Effect size [CI]

(SMD ‐0.72; 95% CI ‐1.28 to ‐0.16)

(SMD ‐0.44; 95% CI ‐0.64 to ‐0.25)

(SMD ‐0.66; 95% CI ‐1.28 to ‐0.05)

(SMD ‐0.72; 95% CI ‐1.28 to ‐0.16)

02 Potent steroid: betamethasone dipropionate

Effect size [CI]

(SMD ‐1.09; 95% CI ‐1.29 to ‐0.90)

(SMD ‐1.00; 95% CI ‐1.19 to ‐0.81)

(SMD ‐1.23; 95% CI ‐1.43 to ‐1.03)

(SMD ‐1.09; 95% CI ‐1.29 to ‐0.90)

03 Potent steroid: betamethasone valerate

Effect size [CI]

(SMD ‐1.40; 95% CI ‐1.75 to ‐1.05)

(SMD ‐1.40; 95% CI ‐1.75 to ‐1.05)

04 Very potent steroid: amcinonide

Effect size [CI]

(SMD ‐1.42; 95% CI ‐1.80 to ‐1.04)

(SMD ‐1.58; 95% CI ‐1.98 to ‐1.18)

(SMD ‐0.97; 95% CI ‐1.33 to ‐0.61)

(SMD ‐1.42; 95% CI ‐1.80 to ‐1.04)

05 Very potent steroid: clobetasol propionate

Effect size [CI]

(SMD ‐1.73; 95% CI ‐1.99 to ‐1.48)

(SMD ‐1.53; 95% CI ‐1.77 to ‐1.28)

(SMD ‐1.57; 95% CI ‐1.81 to ‐1.34)

06 Very potent steroid: halcinonide

Effect size [CI]

(SMD ‐1.11; 95% CI ‐1.69 to ‐0.53)

(SMD ‐1.11; 95% CI ‐1.69 to ‐0.53)

07 Vitamin D in combination: calcipotriol + BMD

Effect size [CI]

(SMD ‐0.97; 95% CI ‐1.61 to ‐0.32)

(SMD ‐0.92; 95% CI ‐1.42 to ‐0.43)

(SMD ‐1.00; 95% CI ‐1.79 to ‐0.22)

(SMD ‐0.97; 95% CI ‐1.61 to ‐0.32)

08 Other treatment: betamethasone‐17,21‐dipropionate plus salicylic acid

Effect size [CI]

(SMD ‐1.48; 95% CI ‐2.50 to ‐0.47)

(SMD ‐1.15; 95% CI ‐2.11 to ‐0.19)

(SMD ‐1.48; 95% CI ‐2.50 to ‐0.47)

09 Other treatment: ciclopirox olamine shampoo

Effect size [CI]

(SMD ‐0.07; 95% CI ‐0.82 to 0.68)

(SMD ‐0.11; 95% CI ‐0.86 to 0.64)

(SMD ‐0.07; 95% CI ‐0.82 to 0.68)

10 Other treatment: fluocinolone acetonide, plus occlusion

Effect size [CI]

(SMD ‐1.22; 95% CI ‐1.69 to ‐0.76)

(SMD ‐0.89; 95% CI ‐1.34 to ‐0.44)

(SMD ‐1.22; 95% CI ‐1.69 to ‐0.76)

11 Other treatment: salicylic acid

Effect size [CI]

(SMD ‐0.86; 95% CI ‐1.79 to 0.06)

(SMD ‐0.57; 95% CI ‐1.47 to 0.32)

(SMD ‐0.86; 95% CI ‐1.79 to 0.06)

All treatments

No. participants

2472

2897

0

1875

3011

Between‐patient design

9

12

0

5

13

Within‐patient design

1

0

0

0

1

Treatment duration

2 wks to 8 wks

2 wks to 8 wks

3 wks to 8 wks

2 wks to 8 wks

Sensitivity analysis: potent corticosteroids

Effect size [CI]; I² statistic

(SMD ‐1.18; 95% CI ‐1.40 to ‐0.96); I² statistic: 19.9%

Sensitivity analysis: very potent corticosteroids

Effect size [CI]; I² statistic

(SMD ‐1.51; 95% CI ‐1.70 to ‐1.31); I² statistic: 37.5%

For acronyms, see Table 1.

Figures and Tables -
Table 21. Analysis 18: Trial characteristics and outcomes: scalp psoriasis: placebo‐controlled trials
Table 22. Analysis 19: Trial characteristics and outcomes: scalp psoriasis: vitamin D vs. other treatment

Subcategory

Measure

01 IAGI/IGA

02 TSS

03 PASI

04 PAGI/PGA

05 Combined end point

01 Vitamin D vs. corticosteroid (potent): calcipotriol vs. BMD

Effect size [CI]

(SMD 0.48; 95% CI 0.32 to 0.64)

(SMD 0.45; 95% CI 0.28 to 0.63)

(SMD 0.56; 95% CI 0.31 to 0.81)

(SMD 0.48; 95% CI 0.32 to 0.64)

02 Vitamin D vs. corticosteroid (potent): calcipotriol vs. BMV

Effect size [CI]

(SMD 0.37; 95% CI 0.20 to 0.55)

(SMD 0.09; 95% CI ‐0.09 to 0.27)

(SMD 0.41; 95% CI 0.22 to 0.59)

(SMD 0.37; 95% CI 0.20 to 0.55)

03 Vitamin D vs. corticosteroid (very potent): calcipotriol vs. clobetasol propionate

Effect size [CI]

(SMD 0.37; 95% CI 0.05 to 0.69)

(SMD 0.37; 95% CI 0.05 to 0.69)

04 Vitamin D + corticosteroid vs. corticosteroid: calcipotriol + BMD vs. BMD

Effect size [CI]

(SMD ‐0.18; 95% CI ‐0.26 to ‐0.10)

(SMD ‐0.19; 95% CI ‐0.27 to ‐0.11)

(SMD ‐0.17; 95% CI ‐0.25 to ‐0.09)

(SMD ‐0.18; 95% CI ‐0.26 to ‐0.10)

05 Vitamin D vs. vitamin D + corticosteroid: calcipotriol vs. calcipotriol + BMD

Effect size [CI]

(SMD 0.64; 95% CI 0.44 to 0.84)

(SMD 0.70; 95% CI 0.56 to 0.84)

(SMD 0.84; 95% CI 0.61 to 1.08)

(SMD 0.64; 95% CI 0.44 to 0.84)

06 Vitamin D vs. other treatments: calcipotriol vs. coal tar polytherapy

Effect size [CI]

(SMD ‐0.24; 95% CI ‐0.73 to 0.25)

(SMD ‐0.30; 95% CI ‐0.84 to 0.24)

(SMD ‐0.45; 95% CI ‐0.92 to 0.02)

All treatments

No. participants

5175

4877

0

3742

5413

Between‐patient design

10

11

0

6

12

Within‐patient design

0

0

0

0

0

Treatment duration

4 wks to 52 wks

4 wks to 8 wks

0

4 wks to 8 wks

4 wks to 52 wks

For acronyms, see Table 1.

Figures and Tables -
Table 22. Analysis 19: Trial characteristics and outcomes: scalp psoriasis: vitamin D vs. other treatment
Table 23. Analysis 04: Trial characteristics and outcomes: dithranol vs. placebo

Subcategory

Measure

01 IAGI/IGA

02 TSS

03 PASI

04 PAGI/PGA

05 Combined end point

01 Dithranol

Effect size [CI], N, I² statistic

(SMD ‐1.06; 95% CI ‐1.66 to ‐0.46); I² statistic: 37.4%

(SMD ‐1.06; 95% CI ‐1.66 to ‐0.46); I² statistic: 37.4%

No. participants

0

47

0

0

47

Between‐patient design

0

0

0

0

0

Within‐patient design

0

3

0

0

3

Treatment duration

3 wks to 8 wks

3 wks to 8 wks

correlation coefficient (rho) = 0

All trials

(SMD ‐0.98; 95% CI ‐1.56 to ‐0.41)

I² statistic: 13.9%

rho = 0

Btw‐patient trials

rho = 0.25

Within‐patient trials

(SMD ‐1.05; 95% CI ‐1.67 to ‐0.44)

I² statistic: 35.4%

rho = 0

Btw‐patient trials

rho = 0.50

Within‐patient trials

(SMD ‐1.12; 95% CI ‐1.75 to ‐0.48)

I² statistic: 56.9%

rho = 0

Btw‐patient trials

rho = 0.75

Within‐patient trials

(SMD ‐1.17; 95% CI ‐1.81 to ‐0.52)

I² statistic: 78.5%

For acronyms, see Table 1.

Figures and Tables -
Table 23. Analysis 04: Trial characteristics and outcomes: dithranol vs. placebo
Table 24. Included studies of adverse events

Study

Methods

Participants

Intervention(s)

Outcomes (AEs)

Summary findings

Notes

Allocation concealment

Andres 2006

DESIGN: between‐patient

patient delivery
ALLOCATION: random
Method of randomisation: computer‐generated list

Concealment: unclear
BLINDING: single‐blind (investigator)
WITHDRAWAL/DROPOUT:
described

N: 26
TD: 4 wks; FU: 4 wks
LF: 0 (0%)
BC: characteristics reported, but not demonstrated to be comparable (shampoo group had more severe disease and higher proportion of males)
Age: 34.3 (9.5SD)
Gender (per cent men): 58%
Severity:
DSS: 5.3 (1.3SD)
% scalp affected: 63.8%
INCLUSION CRITERIA: people with scalp psoriasis affecting > = 25% scalp; DSS > = 3
EXCLUSION CRITERIA: pregnancy or risk thereof; lactation; ophthalmological disorder; contact lens wearer

Clobetasol propionate 0.05% shampoo, OD. Applied to dry scalp, rinsed off after 15 minutes

Clobetasol propionate 0.05% gel, OD. Applied to dry scalp and left in. 

Serum cortisol

atrophogenicity (ultrasound measurement of skin thickness (epidermis + dermis) (mm), averaged over 3 sites of the scalp)

ocular safety (intraocular pressure)

DSS (10‐pt; sum of erythema, adherent desquamation, and plaque thickening; 0 (none) to 3 (severe) with half‐point ratings permitted)

Patient‐reported ocular stinging (0 to 3)

Compliance

Neither formulation had an impact on ocular safety, no report of ocular stinging.

LAE:
CS: 1/14; CG: 2/14

HPA suppression:
CS: 0/14; CG: 2/14

Atrophy:
CS: 0/14; CG: 0/14

Decrease in skin thickness from baseline: mean difference:
CS: 0.04 mm
CG: ‐0.24 mm
(difference: P < = 0.025)

Efficacy results of the 2 formulations were similar. Compliance with protocol was good in both groups.

Exploratory safety study

Sponsored by Galderma Laboratories

Unclear

Barnes 2000

DESIGN: within‐patient
patient delivery

ALLOCATION: non‐random
Method of randomisation: NA
Concealment: NA
BLINDING: open
WITHDRAWAL/DROPOUT: described

N: 202
TD: 52 wks; FU: 52 wks
LF: 64 (32%)
BC: NA
Age: 46 (14.5SD)
Gender (per cent men): 60%
Severity:
Scalp: TSS (0 to 12): 5.9; Overall assessment (investigator): mild (31%); moderate (58%); severe (11%)
Body: PASI (modified): 6.8 Overall assessment (investigator): mild (41.5%); moderate (55%); severe (3.5%)
INCLUSION CRITERIA: chronic plaque psoriasis on scalp and body; adult (≥18); outpatient
EXCLUSION CRITERIA: pregnancy or risk thereof; severe (i.e. requiring additional therapy) or unstable psoriasis; hypercalcaemia; history of hypo‐ or hyperparathyroidism, renal/hepatic disease; systemic or phototherapies within previous 6 wks; other medication that could affect course of disease

Calcipotriol scalp solution 50 mcg/ml BD
plus calcipotriol cream 50 mcg/g BD (up to 70 g/wk)

No control

Local AEs:
number of AEs/participant
% severe AEs
withdrawals due to adverse events (WA)

Systemic AEs:

serum calcium
serum PTH
urinary calcium/creatinine ratio

Local AEs:
the most common local AE was facial irritation (60/202 participants at wk 2), though the incidence declined rapidly over time (1/141 at wk 46).
20% of local AEs considered by investigator to be 'severe'. 14% of participants withdrew because of adverse events

Systemic AEs:
no significant changes observed

Sponsored by Leo Pharmaceuticals

Not applicable

Berth‐Jones 1993; Berth‐Jones 1992c

DESIGN: uncontrolled study
patient delivery
ALLOCATION: non‐random
Method of randomisation: NA

Concealment: NA
BLINDING: open
WITHDRAWAL/DROPOUT: NA

STUDY A:
N: 20
TD: 52 wks; FU: 52 wks
LF: 0 (0%)
BC: NA
Age: 43
Gender (per cent men): 65%
Severity: mean PASI: 7.6 (3.5SD)

STUDY B:
N: intervention: 10 {32 controls}
TD: 4 wks; FU: 4 wks
LF: 0 (0%)
BC: not demonstrated
Age: 48 {42}
Gender (per cent men): 50% {44%}
Severity: mean PASI: 18.0 (13.9SD) {NR}

INCLUSION CRITERIA: people with chronic plaque psoriasis; aged ≥18; under long‐term care of investigators. Study A: compliant patients, responsive to calcipotriol.
Study B: more extensive disease, failing to respond to low doses of topical agents. Controls received no calcipotriol.
EXCLUSION CRITERIA: pregnancy

Study A: calcipotriol ointment 50 mcg/g BD up to 100 g/wk
No control

Study B: calcipotriol ointment 50 mcg/g BD, using 100 g/wk for 4 wks
Control: people using alternative therapies

Local AEs:
not assessed

Systemic AEs: urine calcium and phosphate excretion; serum total calcium, phosphate and alkaline phosphatase

Study A: no significant trend in urine calcium excretion

Study B: significant increase in urine calcium excretion (relative to controls and to baseline)

Sponsorship not reported

For study B, baseline comparability of intervention and control groups not demonstrated.

Berth Jones 1992 reports findings for study A at 10 mths

Not applicable

Bleiker 1998

DESIGN: uncontrolled study
Delivery: unclear

ALLOCATION: non‐random
Method of randomisation: NA

Concealment: NA

BLINDING: open WITHDRAWAL/DROPOUT:

not described

N: 28
TD: 2 wks; FU: 26 wks
LF: unclear
BC: NA
Age: 47 (range: 18 to 83)
Gender (per cent men): 50%
Severity: PASI: 21.4 (range: 8.2 to 53.7)
INCLUSION CRITERIA: inpatients with severe chronic plaque psoriasis (> 15% BSA)
EXCLUSION CRITERIA: renal impairment, pregnancy, lactation, systemic treatment, diuretics

STUDY A: 200 g calcipotriol ointment 50 mcg/g (wk 1) plus 300 g 50 mcg/g calcipotriol (wk 2)

STUDY B: Calcipotriol 50 mcg/g PRN < = 360 g/wk

Local AEs:
not assessed

Systemic AEs:
serum total adjusted calcium
urinary calcium

5 participants developed hypercalcaemia during treatment, all had received a dose > 5 g/kg
9 participants became hypercalciuric during treatment; this was uncorrelated with dose

Sponsorship not reported

Not applicable

Brodell 2011b

DESIGN: uncontrolled study
patient delivery
ALLOCATION: non‐randomised
BLINDING: open
WITHDRAWAL/DROPOUT: not described

N: 305
TD: 12 wks; FU: 12
LF: unclear
BC: NA
Age: 50.3 (13.7SD); range: 22 to 84
Gender (per cent men): 61.8%
Severity:
ODS: all patients scored as moderate/severe/very severe
% BSA: 7.1%

% white: 91.8%
INCLUSION CRITERIA: people with moderate to severe plaque psoriasis; affected; aged 18 to 80
EXCLUSION CRITERIA: not stated

Clobetasol propionate 0.05% spray BD (2 to 4 wks); treatment responders (ODS < = 3) then treated with calcitriol 3 mg/g ointment (8 wks)

Pruritis, telangiectasias, burning/stinging (0 to 3), skin atrophy, folliculitis

Overall disease severity (ODS) (5‐pt: 0 = clear to 4 = severe/very severe) based on erythema, scaling, and plaque elevation.

Treatment success (change from baseline ODS > = 1 at wk 12)

 

 

At 4 wks:

skin atrophy 7/285

telangiectasias 2/285

stinging/Burning 39/285

folliculitis 11/285

 

At 12 wks:

skin atrophy 2/235

telangiectasias 5/235

stinging/Burning 35/235

folliculitis 3/235

 

Any adverse event: 100/305

 

Sponsored by Galderma laboratories

Not applicable

Corbett 1976

DESIGN: within‐patient
patient delivery
ALLOCATION: random
Method of randomisation: NR
Concealment: unclear
BLINDING: double‐blind (participant/investigator)
WITHDRAWAL/DROPOUT: not described

N: 14
TD: 26 wks; FU: 26 wks
LF: 2 (14.3%)
BC (clinical): NR Age: 44 (18.4SD) Gender (per cent men): 64%
Severity: NR INCLUSION CRITERIA: bilateral psoriasis involving < = 15% BSA; willing to participate for 6 months

EXCLUSION CRITERIA: NR

Clobetasol propionate 0.05% ointment, BD Betamethasone valerate 0.1% ointment, BD

Local AEs: NR

Systemic AEs:
synacthen test for function of pituitary‐adrenal axis at 0, 3, and 6 months

Quantities used by study participants were small (mean: 7 g/wk)

No pituitary‐adrenal suppression observed

Sponsorship not reported

Unclear

Gerritsen 2001; Langner 1996; van de Kerkhof 1996c

DESIGN: uncontrolled study

patient delivery

ALLOCATION: NA

Method of randomisation: NA

Concealment: NA

BLINDING: open WITHDRAWAL/DROPOUT: described

N: 257
TD: < = 78 wks; FU: <= 78 wks
LF: 4 (1.6%)
BC: NA
Age: 42 (13SD)
Gender (per cent men): 61.3%
Severity: BSA: 14.0% (14.2%SD); PASI: 9.7; 47% had severe disease
INCLUSION CRITERIA: chronic plaque psoriasis; aged ≥18
EXCLUSION CRITERIA: non‐compliant; pregnancy; use of systemic/phototherapy within previous 2 mths; use of topical therapy within previous 1 wk; concomitant disease; clinically relevant abnormality in laboratory assessments; known hypersensitivity to vitamin D/vehicle

Calcitriol 3 mcg/g BD

No control

Local AEs:
serious AEs reported; withdrawals due to adverse events (WA)

Systemic AEs:
laboratory levels for: protein albumin; calcium, phosphorus, sodium, potassium, plasma calcitriol
Urinary calcium, creatinine, phosphorus; creatinine clearance; urinary calcium/creatinine ratio

Local AEs:
WA: 7/253;
AEs: 37/353;
no serious local adverse events

Systemic AEs: WA: 1/253. 4 additional participants experienced hypercalcaemia. All mean values for all parameters remained within normal levels. Mean use: 6 g/day (range: 1 to 24 g/day)

Sponsored by Solvay‐Duphar BV

Excludes scalp

Not applicable

Guzzo 1996

DESIGN: between‐patient
patient delivery

ALLOCATION: random
Method of randomisation: NR
Concealment: unclear
BLINDING: double‐blind (participant/investigator)
WITHDRAWAL/DROPOUT: described

N: 78
TD: 8 wks; FU: 8 wks
LF: 2 (2.6%)
BC: no (1 statistically significant difference (% BSA higher in intervention group)
Age: 48
Gender (per cent men): 67%
Severity: mean BSA: 9%
INCLUSION CRITERIA: aged ≥18; stable plaque psoriasis; BSA: 5% to 20%

EXCLUSION CRITERIA: hypercalcaemia, bone, thyroid or parathyroid disease; topical therapy within previous 2 wks; systemic/phototherapy within previous 8 wks

Calcipotriol 50 mcg/g ointment BD, up to 120 g/wk

Placebo

Local AEs: not assessed

Systemic AEs: blood and urine chemistry analysis: parathyroid hormone, serum calcium, bone‐specific alkaline phosphatase, urinary hyroxyproline, 24‐hr urinary calcium excretion. Bone densitometry

No adverse effects on bone metabolism or calcium

Sponsored by Bristol‐Myers Squibb

Unclear

Heng 1990

DESIGN: between‐patient (retrospective study)
patient delivery

ALLOCATION: non‐random
Method of randomisation: NA
Concealment: NA
BLINDING: NA
WITHDRAWAL/DROPOUT: NA

N: 28
TD: 6 mths to 12 ys; FU: 6 mths to 12 years
LF: NA
BC: demographic: yes; clinical: not demonstrated
Age: 49 (13SD)
Gender (per cent men): 82%
Severity: NR INCLUSION CRITERIA: psoriasis (any severity; types include plaque (16), generalised, seborrhoeic, guttate, erythrodermic); previous prolonged treatment with topical fluorinated steroids (range: 6 mths to 12 years). Control group matched for age and gender

EXCLUSION CRITERIA: NR

Previous prolonged treatment with topical fluorinated steroids

Control: 'steroid‐negative' group ‐ previous tar/UVB/sunlight or no treatment

Local AEs: light/electron microscopy for examination of basal keratinocyte herniation (BKH); layers of basement membrane

Systemic AEs: NR

Local AEs: light microscopy revealed no between‐group differences. Electron microscopy revealed multi‐layered, fragmented and disorganised basal laminae in the steroid group, which appeared to be correlated with duration of treatment. Fragmentation was not observed in the control group

Sponsorship not reported

Non‐psoriatic control group also considered

16/28 participants had plaque psoriasis

Not applicable

Katz 1987b

DESIGN: between‐patient
patient delivery

ALLOCATION: random

Method of randomisation: NS
Concealment: unclear
BLINDING: double‐blind (participant/investigator)
WITHDRAWAL/DROPOUT: described

N: 40
TD: 3 wks; FU: 3 wks
LF: NA
BC: demographic: yes; clinical: yes (gender imbalance)
Age: 44 (range: 18 to 66)
Gender (per cent men): 53%
Severity: 55% moderate disease; 45% severe disease
INCLUSION CRITERIA:
aged ≥ 18; stable or worsening, moderate or severe chronic plaque psoriasis; baseline laboratory values within normal range (5 to 25 mcg%)
EXCLUSION CRITERIA: pregnancy or risk thereof; lactation; hypersensitivity to study medications; concurrent medication that could affect study outcomes; use of systemic therapies within previous 4 wks; use of topical therapies within previous 2 wks

Betamethasone dipropionate (0.05%) in optimised vehicle BD; Clobetasol 17 propionate (0.05%) ointment BD

Local AEs: not assessed

Systemic AEs: morning plasma cortisol levels; 24‐hr urine steroid levels; FBC, blood chemistry, urinalysis

Temporary reversible suppression of the hypothalamic‐pituitary‐adrenal axis in 8/40 participants

Sponsorship not reported; 1 author from Schering Corporation

Unclear

Katz 1989

DESIGN: within‐patient
patient delivery

ALLOCATION: random
Method of randomisation: unclear
Concealment: unclear

BLINDING: double‐blind (participant/investigator)
WITHDRAWAL/DROPOUT: described

N: 30
TD: 2 wks; FU: 4 wks
LF: 0 (0%)
BC: yes
Age: 55 (range: 36 to 69)
Gender (per cent men): 53%
Severity: NR INCLUSION CRITERIA: bilateral symmetric chronic plaque psoriasis EXCLUSION CRITERIA: pregnancy or risk thereof; people with overt signs of atrophy

Betamethasone dipropionate (0.05%) in optimised vehicle BD (BMD)

Clobetasol propionate (0.05%) ointment BD (CP)

Uninvolved (non‐psoriatic) area used as test area for each participant

Local AEs: skin surface microscopic examination with photographic documentation; oil and magnifying (8 x) lens to detect 'preatrophy' (visibility of subpapillary vascular plexus caused by thinning of epidermis and papillary dermis)

Systemic AEs: NR

Local AEs: no serious adverse events observed with either treatment. Preatrophy identified in 20% of involved plaques (BMD: 11/59; CP: 12/59) and was more likely in females. In the test area (non‐psoriatic skin), 5% of plaques showed preatrophy (BMD: 2/30; CP: 1/30). Preatrophy appeared to be usually reversible following treatment cessation.

Sponsored by Schering Corporation

Unclear

Kimball 2008

Phase II

DESIGN: uncontrolled
patient delivery
ALLOCATION: unclear

BLINDING: open WITHDRAWAL/DROPOUT:
described

N: 32
TD: 2 wks; FU: NS
LF: 1 (3.1%)
BC: NA
Age: 24 to 72
Gender (per cent men): NS
Severity: NS
% white: 94%
INCLUSION CRITERIA
people with mild to moderate plaque psoriasis; aged > = 12
EXCLUSION CRITERIA: NS

Clobetasol 0.05% foam BD

Clobetasol 0.05% ointment BD (= 7 g/day, up to 50 g/wk)

 

 

Maximal plasma concentration of clobetasol propionate

 

Higher but non‐significant levels of clobetasol in ointment group

Supported by Stiefel Laboratories, Inc.

Review of phase II studies on AD and psoriasis (clobetasol foam)

Not applicable

Kimball 2008

Phase III

DESIGN: between‐patient
patient delivery
ALLOCATION: random
Method of randomisation: not stated
Concealment: unclear
BLINDING: double‐blind (participant/investigator)
WITHDRAWAL/DROPOUT: described

N: 497
TD: 2 wks; FU: NS
LF: 16 (3%)
BC: NS
Age: NS
Gender (per cent men): NS
Severity: most had baseline ISGA of 3
INCLUSION CRITERIA: people with mild to moderate plaque psoriasis; aged > = 12
EXCLUSION CRITERIA: NS

Clobetasol 0.05% foam BD

Clobetasol 0.05% ointment BD

Placebo foam BD

Face, scalp, and intertriginous areas excluded from treatment

 

Treatment‐related adverse events:

  • all

  • atrophy

  • burning

  • pruritis

  • folliculitis

ISGA (investigator's static global assessment score)(scale NR)

Atrophy:

C foam: 2% (N = 253)
C ointment: NS (N = 121)
Placebo foam: 1% (N = 123)

Burning:

C foam: 2% (N = 253)
C ointment: NS (N = 121)
Placebo foam: 2% (N = 123)

All treatment‐related adverse events:

C foam: 8% (N = 253)
C ointment: 2% (N = 121)
Placebo foam: 7% (N = 123)

 

Supported by Stiefel Laboratories Inc.

Review of phase III studies on AD and psoriasis (clobetasol foam).

Unclear

Kragballe 1991b

DESIGN: uncontrolled study

patient delivery

ALLOCATION: non‐random
Method of randomisation: NA Concealment: NA

BLINDING: open WITHDRAWAL/DROPOUT: described

N: 15
TD: 26 wks; FU: 26 wks
LF: 1(6.7%)
BC: NA
Age: 42 (range: 21 to 71)
Gender (per cent men): 53%
Severity: % BSA: 14% (range: 5% to 30%)
Most 'moderate' severity
INCLUSION CRITERIA: participants previously responding to calcipotriol during 8‐wk clinical trial, but who had since relapsed

EXCLUSION CRITERIA: hypercalcaemia, impaired renal/hepatic function, daily receiving > 400 i.u. vitamin D

Calcipotriol ointment 50 mcg/g BD (max: 100 g/wk)

No control

Local AEs: patient report of adverse events
Investigator report of adverse events (skin examination). Skin biopsies to determine histologic signs of epidermal and dermal atrophy.

Systemic AEs: laboratory tests: FBC, serum alkaline phosphatase, aspartate aminotransferase, bilirubin, creatinine, total calcium, total phosphate

Local AEs:
AE(L): 3/15 (reported to be transient & mild).
Cases of mild to moderate atrophy found in 4/8 participants

Systemic AEs: no consistent changes in laboratory analyses, with no clinically important changes in serum calcium

Sponsorship not reported. Leo Pharmaceuticals supplied study medication

Face and scalp treated with emollient or hydrocortisone cream 1% (not calcipotriol)

Not applicable

Lambert 2002

DESIGN: uncontrolled study

patient delivery

ALLOCATION: non‐random
Method of randomisation: NA
Concealment: NA
BLINDING: open
WITHDRAWAL/DROPOUT: described

N: 157
TD: 26 wks; FU: 26 wks
LF: 8 (5.1%)
BC: NA
Age: 44.4 (14.0SD)
Gender (per cent men): 57%
Severity: mean BSA: 13%; mean PASI: 9.4 (5.4SD)

INCLUSION CRITERIA: chronic plaque psoriasis; aged 18 to 70; BSA 7% to 20%; laboratory parameters normal at baseline

EXCLUSION CRITERIA: pregnancy or risk thereof; topical antipsoriatic therapy within previous 2 wks; systemic antipsoriatic therapy within previous 6 wks; retinoids within previous 52 wks.; history of hyperparathyroidism; concomitant use of drugs affecting calcium metabolism

Tacalcitol ointment, 4 mcg/g OD. No control

Local AEs: participants asked about adverse events. Tolerability assessed by investigator (4‐pt: 1 = excellent to 4 = poor).

Systemic AEs:
Routine haematology and biochemistry: FBC, haemoglobin, bilirubin, creatinine, alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, gamma glutamyltranspeptidase, calcium, phosphate, sodium, potassium, glucose, urea, albumin. Urinalysis: calcium, creatinine, phosphate.

Local AEs:
WA: 5/157 (3.4%) (treatment‐related).
AE(L): 26/157 (transient skin irritation)
Tolerability at least moderate in 95% of participants

Systemic AEs: no serious adverse events and no hypercalcaemia

Sponsored by Hermal/BHI, Germany

Scalp excluded

Similar study to van de Kerkhof 2002, but unclear whether Lambert 2002 is a report of a subgroup or a distinct study

Not applicable

Lebwohl 1998b

DESIGN: between‐patient
patient delivery

ALLOCATION: random.
Method of randomisation: unclear
Concealment: unclear
BLINDING: double‐blind (participant/investigator)
WITHDRAWAL/DROPOUT: described

N: 40
TD: 26 wks; FU: 26 wks
LF: 4 (10%)
BC: no (Group A had less severe disease at baseline)
Age: NR
Gender (per cent men): NR
Severity: mild to moderate psoriasis
INCLUSION CRITERIA: people with at least moderate improvement in response to initial 2‐wk therapy regimen; aged ≥18; stable disease; BSA < = 20% (excluding face/scalp); plaque elevation at least moderate; willing to comply with study protocol

EXCLUSION CRITERIA: history of sensitivity to study ingredients; topical antipsoriatics within previous 2 wks; UVB/PUVA within previous 8 wks; history of hypercalcaemia, recurrent illness

Initial regimen: all participants received 2 wks of calcipotriol (OM), halobetasol ointment (ON)

Group A: Calcipotriol ointment 50 mcg/g (weekdays) plus halobetasol 0.05% ointment BD (weekends)

Group B: Placebo ointment (weekdays) plus halobetasol 0.05% ointment BD (weekends)

Local AEs: treatment‐related adverse events

Systemic AEs: not assessed

Local AEs:
AE(L) (treatment‐related; all irritant contact dermatitis): Group A: 4/17 Group B: 1/20 No cutaneous atrophy observed

Sponsored by Westwood Squibb Pharmaceuticals

Unclear

Lebwohl 2001

DESIGN: between‐patient

patient delivery

ALLOCATION: random
Method of randomisation: NR
Concealment: unclear
BLINDING: double‐blind (participant/investigator)
WITHDRAWAL/DROPOUT: not described

N: 50
TD: 26 wks; FU: 26 wks
LF: NR
BC: NR
Age: 55
Gender (per cent men): NR
Severity: NR INCLUSION CRITERIA: moderate to severe plaque psoriasis; BSA < = 15%. All participants participated in an open‐label treatment phase for 6 wks (tazarotene gel 0.1% OM, clobetasol propionate ointment 0.05% ON) EXCLUSION CRITERIA: topical antipsoriatic treatment within previous 2 wks; UV treatment within previous 4 wks; systemic antipsoriatic treatment within previous 8 wks

Open‐label phase: tazarotene 0.1% gel plus clobetasol propionate 0.05% ointment for 6 wks. Once daily initially, then 'tapered'.

Maintenance phase (20 wks): tazarotene gel, 0.1%, OM (3/7 days), plus clobetasol propionate 0.05% ointment ON (2/7days) (TC)

Tazarotene gel, 0.1%, OM (3/7 days), placebo ointment OM (2/7 days), placebo ointment ON (2/7 days) (TP)

Placebo gel OM (3/7 days), placebo ointment ON (2/7 days) (P)

Local AEs: no. steroid‐specific side‐effects
Withdrawals due to adverse events (WA) Drug‐related adverse events
Systemic AEs: not assessed

Local AEs: no steroid‐specific side‐effects
WA: 0/50
AE(L) (treatment‐related): TC: 24% TP: 29% P: 0%

Sponsorship: not reported

No adequate effectiveness data reported. Numbers of participants in each group NR

Unclear

Menter 2007; Feldman 2007a

DESIGN: uncontrolled
patient delivery
ALLOCATION: NA

BLINDING: open
WITHDRAWAL/DROPOUT: described

N: 1423
TD: 4 wks; FU: 4 wks
LF: 2 (0.1%)
BC: NA
Age: 49.7 (14.7SD)
Gender (per cent men): NS
Severity:
Duration (yrs): 12.5 (13SD)
BSA: 10.6% (5.75% SD)
INCLUSION CRITERIA:
people with moderate to severe plaque psoriasis; 3% to 20% BSA involvement
EXCLUSION CRITERIA: current systemic therapy, phototherapy or topical therapy

Clobetasol 0.05% foam BD, up to 50 g/wk either as monotherapy or adjunctive to existing therapy

 

Erythema, peeling/scaling, dryness, stinging/burning (0 none to 3 severe).

Telangiectasia, skin atrophy, pruritus, folliculitis (absent/present)

 

Also assessed efficacy and QoL

Erythema: 23.7%
peeling/scaling: 21.0%
dryness: 28.3%
stinging/burning: 15.1%

Telangiectasia, skin atrophy, folliculitis: present in less than 1% of participants (findings not reported separately)

Pruritus: 5.7%

Clobex Spray Community‐Based Research Assessment (COBRA)

Sponsorship not reported

Not applicable

Miyachi 2002

DESIGN: uncontrolled study

patient delivery

ALLOCATION: non‐random
Method of randomisation: NA
Concealment: NA
BLINDING: open
WITHDRAWAL/DROPOUT: described

N: 160
TD: 54 wks; FU: 54 wks
LF: 6 (3.8%)
BC: NA
Age: 48.2 (16.1SD)
Gender (per cent men): 82%
Severity: mean PASI: 22.49 (10.2SD) INCLUSION CRITERIA: inpatients and outpatients with BSA ≥10% EXCLUSION CRITERIA: pregnancy; lactation; severe liver disease, heart disease, impaired renal function, hypercalcaemia; treatment with topical, UV or systemic antipsoriatics within previous 2 wks

Tacalcitol ointment 20 mcg/g OD (max: 10 g/day)

No control

Local AEs: treatment‐related adverse events

Systemic events: haematological tests (FBC), blood biochemical tests (calcium, inorganic phosphorus, albumin, protein, bilirubin, urea nitrogen, creatinine, GP/AST, GPT/ALT, alkaline phosphatase, LDH, intact PTH), urinalysis (glucose, protein); serum tacalcitol and vitamin D₃ levels.

Local AEs:
AE(L): 16/154 (29 events, all mild to moderate)

Systemic AEs:
AE(S): 85/154 (155 events, of which 6 were considered treatment‐related). Serum levels of intact PTH and tacalcitol decreased, suggesting percutaneous absorption of tacalcitol. However, mean levels of serum calcium remained within the standard level. Data on individual responses not reported.
High‐dose tacalcitol affected serum calcium in participants with reduced renal function

Sponsorship: not reported

Scalp treated in 74/154 participants

Usual dosing regimen for tacalcitol is 4 mcg/g OD

Not applicable

Poyner 1993

DESIGN: uncontrolled study

patient delivery

ALLOCATION: non‐random
Method of randomisation: NA
Concealment: NA

BLINDING: open
WITHDRAWAL/DROPOUT: described

N: 203
TD: 48 wks; FU: 48 wks
LF: 59 (29.1%)
BC: NA
Age: 43.8 (range: 17 to 80)
Gender (per cent men): 52.7%
Severity (assessment methods NR): mild (8%); moderate (63%); severe (30%) INCLUSION CRITERIA: aged ≥18; chronic plaque psoriasis ≥ 100 cm². EXCLUSION CRITERIA: PUVA within previous 8 wks; elevated serum calcium, unstable disease, impaired hepatic/renal function' pregnancy; concomitant oral calcium/vitamin D. topical antipsoriatics, lithium, systemic steroids

Calcipotriol 50 mcg/g ointment

No control

Loca AEs: self report of adverse events.
Withdrawals due to adverse events (WA)

Systemic AEs: biochemical and haematological tests

Compliance: self‐reported usage at each visit; weighing of ointment tubes

Local AEs:
WA: 8/203
AE(L): 83/203
142 events reported by 83 (41%) participants with 20.2% being lesional/perilesional irritation

Systemic AEs: no significant changes in haematological values. Mean serum calcium did not change significantly over study period. Significant fall in serum urate in those treated ≥ 36 wks

Compliance: median weekly use (wks 0 to 5): 16.5g; (wks 43 to 48): 11.6g

Sponsored by Leo Pharmaceuticals

Face/scalp excluded

Not applicable

Ramsay 1994

DESIGN: uncontrolled open study
patient delivery

ALLOCATION: non‐random
Method of randomisation: NA
Concealment: NA
BLINDING: open
WITHDRAWAL/DROPOUT: described

N: 167 TD: 52 wks; FU: 52 wks LF: 39 (23.4%)

BC: NA

Age: 49 (range: 20 to 85)

Gender (per cent men): 60%

Severity: PASI (modified): 8.1 (6.7SD)

INCLUSION CRITERIA: chronic plaque psoriasis; previous response to calcipotriol; managed by specialists EXCLUSION CRITERIA: pregnancy or risk thereof; abnormal serum calcium or phosphate; impaired hepatic/renal function; concomitant oral calcium/vitamin D; systemic therapy within previous 8 wks; topical therapy within previous 4 wks

Calcipotriol 50 mcg/g ointment. Max dose: 100 g/wk; 2500 g/pa Face/scalp/neck excluded

No control

Local AEs: self report of adverse events: mild, moderate, severe; unlikely, possibly, or probably treatment‐related

Systemic AEs: haematology (erythrocyte, haemoglobin, leukocyte, platelet counts) and biochemistry (bilirubin, AST/ALT, alkaline phosphatase, albumin, urate, creatinine, phosphate, total calcium) tests Compliance: self report of number tubes used and number daily doses

AE(L): 52/161 60 (46 considered to be treatment‐related) events reported by 52 of 161 participants. 1 participant developed a significant rise in serum calcium. No other abnormalities in haematology or biochemistry tests. 118/161 participants reported continuous medication use and 80% to 90% used it twice daily. Mean use: 35.1 g/wk ('initially') to 23.4 g/wk during last 6 mths

Sponsored by Leo Pharmaceuticals

Not applicable

Roelofzen 2010

DESIGN: observational study using retrospective data (medical records, cancer registry) and prospective (survey) data (treatments/lifestyle). Multivariate proportional hazards regression.
ALLOCATION: NA
BLINDING: NA
WITHDRAWAL/DROPOUT: described

N: 4315
TD: pix lithantracis (med): 4 mths (1 to 300 mths) liquor carbonis detergens (med): 6 mths (1 to 500 mths)
FU: (med) 21 yrs
LF: 329 (7.6%)
BC: NA
Age (at diagnosis): 31 (0 to 95.7)
Gender (per cent men): 52%
Severity: % BSA < 1%: 9%
% BSA 2% to 9%: 30%
% BSA 10% to 30%: 39%
% BSA > 30%: 22%
INCLUSION CRITERIA: people with psoriasis or eczema, diagnosed 1960 to 1990 and treated in 1 of 3 Dutch hospitals;
EXCLUSION CRITERIA: people who could not be traced

All topical, phototherapy, and systemic therapies. Focus of study is on coal tar:

  • Liquor carbonis only (LCD)

  • Pix lithantiacis (PL)

Any cancer

Skin cancer

Internal malignancies

Specific tumour groups:

  • haematological

  • breast

  • lung

  • gastrointestinal

  • bladder/urinary tract

  • prostate

  • female reproductive organs

No statistically significant increased risk of any cancer.

Hazard ratios:

Any cancer:

LCD: 0.85 (95% CI 0.60 to 1.19)
PL: 0.64 (95% CI 0.40 to 1.03)

Skin cancer:

LCD: 1.35 (95% CI 0.53 to 3.44)
PL: 0.33 (95% CI 0.07 to 1.69)

Analysis adjusted for smoking status, other treatments, skin type, alcohol consumption.  However, data on duration of tar therapy, smoking status and alcohol consumption were missing for most participants

Not applicable‐

van de Kerkhof 1997b

DESIGN: uncontrolled study

patient delivery

ALLOCATION: non‐random
Method of randomisation: NA Concealment: NA

BLINDING: open
WITHDRAWAL/DROPOUT: described

N: 58
TD: < = 60 wks; FU: < = 60 wks
LF: 16 (27.6%)
BC: NA
Age: 45 (range: 19 to 78)
Gender (per cent men): 69.0%
Severity: BSA: 8.6% (3.9SD); TSS (0 to 12):7.9 (2.1SD) INCLUSION CRITERIA: people with chronic plaque psoriasis participating in previous double‐blind study (Van de Kerkhof 1996b); aged 25 to 80; normal serum calcium/phosphate. EXCLUSION CRITERIA: pregnancy or risk thereof; topical therapy within previous 4 wks; systemic therapy within previous 8 wks; serious disease; known allergy to study medication; concomitant medication that could interfere with study drug or systemic calcium metabolism

Part 1: double‐blind study (8 wks): tacalcitol 4 mcg/g ointment OD Placebo

Part 2: open follow‐up study (4 wk wash‐out period): tacalcitol 4 mcg/g ointment OD, < = 20 mg/day and < 2000 g per participant over study period. Participants could discontinue treatment after 12 wks

No control

Local AEs: occurrence of adverse events (duration, severity, and whether treatment‐related)
Participant and investigator assessments of tolerability (4‐pt: v. good (3) to insufficient (0))

Systemic AEs: haematology (erythrocytes, platelets, haemoglobin, haematocrit); blood chemistry (serum calcium, inorganic phosphate, creatinine, ASAT, alkaline phosphatase, LDH)

Local AEs:
WA: 0/58
AE(L): 10/58 (19 events) AE(L)(treatment‐related): 8/58
Tolerability: investigator assessment: 2.60 (0.53SD, N = 58); participant assessment: 2.53 (0.63SD, N = 58)

Systemic AEs:
AE(S): 0/58

No case of hypercalcaemia

Sponsorship not reported

Follow‐up study to Van de Kerkhof 1996b ‐ 3 of 15 centres participated

Scalp excluded

Not applicable

van de Kerkhof 2002c (see also Lambert 2002)

DESIGN: uncontrolled study

patient delivery

ALLOCATION: non‐random

Method of randomisation: NA

Concealment: NA

BLINDING: open WITHDRAWAL/DROPOUT: described

Part 1:
N: 304
TD: 13 wks; FU: 13 wks
LF: 47 (15.5%)
BC: NA
Age: 44 (range: 15 to 76)
Gender (per cent men): 57%
Severity: median PASI (modified to exclude head): 9.5 (range: 2.2 to 24.4); TSS (0 to 12): 6.0

Part 2: n: 197
TD: 65 wks; FU: 65 wks
LF: 83 (42.1%)
BC: NA
Age: NR
Gender (per cent men): NR
Severity: NR
INCLUSION CRITERIA: chronic plaque psoriasis; BSA 7% to 20% (excluding scalp); aged 18 to 70; normal baseline laboratory values

Part 2 of study: responders to part 1 (≥ 30% reduction in sum score (TSS) from baseline)

EXCLUSION CRITERIA: topical steroids in previous 2 wks; systemic antipsoriatics within previous 6 wks; retinoids within previous 52 wks; known hypersensitivity to vitamin D₃ analogues; serious concomitant disease; disease that might interfere with study assessments; concomitant use of oral calcium/vitamin D; pregnancy or risk thereof

Tacalcitol 4 mcg/g OD. Treatment discontinued during remission and restarted if relapse

No control

Local AEs: number treatment‐related adverse events; withdrawals due to adverse events (WA); investigator assessment of tolerability; participant assessment of tolerability

Systemic AEs: Haematology: serum calcium, parathyroid hormone (PTH), calcitonin, calcitriol Urine: calcium, creatinine, calcium/creatinine ratio. Compliance with medication

Local AEs:
WA: 18/304
AE(L): 65/304
Tolerability excellent/good in 76% (patient assessment) to 92% (investigator assessment) of participants at final assessment.

Systemic AEs:
No clinically significant changes in routine haematology, urinalysis or serum chemistry. Compliance with treatment regimen varied between 82% and 92%. However, 54% of those with BSA 10% to 20% exceeded recommended daily dose of 5 g (up to 13 g daily), but there was no effect on calcium homeostasis. Duration of excess dosing not reported

Sponsored by Hermal/BHI, Germany

Scalp excluded

Not applicable

Vazquez‐Lopez 2004

DESIGN: uncontrolled study

patient delivery

ALLOCATION: non‐random
Method of randomisation: NA
Concealment: NA

BLINDING: open WITHDRAWAL/DROPOUT: described

N: 20
TD: 26 wks; FU: 34 wks
LF: 0 (0%)
BC: NA
Age: 28.2 (range: 20 to 55)
Gender (per cent men): 40%
Severity: NR

INCLUSION CRITERIA:
absence of visible or dermascopic red lines (linear telangiectasias)

EXCLUSION CRITERIA: use of topical steroids in previous 2 mths

Clobetasol propionate 0.05% cream, OD (weekends) plus calcipotriol 50 mcg/g ointment BD (weekdays)

No control

Local AEs: clinical (naked eye) examination of psoriatic plaque and surrounding area
Dermoscopic examination of psoriatic plaque and surrounding area

Systemic AEs: NR

Compliance: quantity and frequency of study drug use (tubes weighed)

Overuse of topical steroids resulted in appearance of clinically unapparent but dermoscopically apparent linear telangiectasias. 7/20 participants failed to adhere to recommended steroid dosing schedules. Dermoscopic red lines not apparent in 15/20 participants. Dermoscopic red lines apparent in 5/20 participants, of whom 4 had overused topical steroid cream. Steroid discontinued in participants with red lines and there was complete resolution within 2 mths

Links compliance with adverse events

Study received no funding

Not applicable

Veraldi 2006

DESIGN: uncontrolled study
patient delivery
ALLOCATION: sequential recruitment
BLINDING: open
WITHDRAWAL/DROPOUT: described

N: 48
TD: 45 dys; FU: 45 dys
LF: 5 (10.4%)
BC: NA
Age: 48.9 (range: 21 to 71)
Gender (per cent men): 62.5%
Severity: NR
INCLUSION CRITERIA: people with chronic stable plaque psoriasis; % BSA < = 20%
EXCLUSION CRITERIA: use of antipsoriatic therapy within previous 2 wks; concurrent use of other topical, photo or systemic therapies

0.1% tazarotene gel, short contact therapy (applied OD for 20 minutes then rinsed off with water)

Pruritis (4‐pt: 0 = absent to 3 = severe)

Burning (4‐pt: 0 = absent to 3 = severe)

At day 45: pruritis (0 to 3): 0.17 (0.38SD)

14/43 had mild pruritis

 

Burning (0 to 3) 0.17 (0.38SD)

14/43

14/43 had mild burning

No participant withdrew because of irritation on treated lesion

Sponsorship not reported

Not applicable

Wishart 1994

DESIGN: uncontrolled study

patient delivery
ALLOCATION: groups determined according to BSA affected.
BLINDING: open
WITHDRAWAL/DROPOUT: described

N: 30
TD: 6 wks; FU: 6 wks
LF: 1 (3%)
BC: NA
Age: 42.5 (13.2SD)
Gender (per cent men): 47%
Severity:
Duration (mths): 202 (176SD)
INCLUSION CRITERIA: people aged >18 with severe chronic plaque psoriasis; lesion severity > = 3 (GSS 0 to 4)
EXCLUSION CRITERIA: pregnancy, other type of psoriasis, concurrent use of medicines containing calcium or vitamin D, antacids or digitalis

Calcitriol 15 mcg/g ointment OD

Quantity of study drug varied by group:

Group 1 (N =12): 4% to 8% BSA treated (300 to 600 cm^2)

Group 2 (N = 10): 8% to 15% BSA treated (600 to 1200 cm^2)

Group 3 (N = 8): 15% to 30% BSA treated (1200 to 2400 cm^2)

IAGI (6‐pt)

ECG

Haematology, biochemistry, urine protein and glucose.

Serum calcium, phosphorus, plasma PTH, serum 25‐hydroxyvitaim D, 1‐alpha,25dihydroxy‐vitaim D, 24 hr urine tests for calcium, creatinine and phosphorus.

Compliance also assessed (medication weight)

Mean daily usage: 74.0 to 306.1 mcg.

No systemic adverse events, no skin irritation.

No clinically relevant changes in vital signs, haematology, biochemistry, urine or ECGs.

IAGI (0 to 5): ‐3.57 (1.01SD, N = 30)

Usual dose is 3 mcg/g BD, max. 30 g daily

Sponsored by Solvay Duphar

Not applicable

per cent men: per cent male; AE(L): number local adverse events/number participants; AE(S): number systemic adverse events/number participants; AE: adverse events; BC: baseline comparability; BD: twice daily; BSA: body surface area; FU: follow up (includes TD); N: number enrolled; NA: not applicable; NR: not reported; OD: once daily; PASI: Psoriasis Area and Severity Index; PRN: as required; TD: treatment duration; TSS: Total Severity Score; WA: withdrawal due to adverse events

Figures and Tables -
Table 24. Included studies of adverse events
Table 25. Excluded studies of adverse events

Study

Reason for exclusion

Aste 2004

Follow‐up under 12 wks and not focused on adverse events

Bos 2002

Not psoriasis, short review (letter)

Breneman 2007

Not a product included in our review (bexarotene gel 1%)

Carboni 2005

Not focused on adverse events

Feldman 2007a

Evaluated add‐on clobetasol for participants treated concurrently with topical or systemic therapy

Floden 1975

Inadequate reporting of adverse events

Franssen 1999

Small (N = 54) retrospective study using participant questionnaires ‐ aimed to identify teratogenetic effects of tar, but many women unable to recall whether tar used in pregnancy

Hong 2010; Hong 2011

Not chronic plaque psoriasis: paediatric dermatology participants had eczema or "eczema–psoriasis overlap (atopic dermatitis with associated features of psoriasis)"

Jacobi 2008

Small uncontrolled short‐term and already reflected in results from main review

Kang 1998

Short‐term and already reflected in results from main review

Lebwohl 1996

Follow‐up under 12 wks and not focused on adverse events

Park 2002

Case study

Senter 1983

Adverse events not reported

Singh 2000

Short‐term (4 weeks) and brief mention of adverse events

Stevanovic 1977

Short‐term, unclear if psoriasis, small numbers (N = 6)

Traulsen 2003

Participants were healthy volunteers

Uhoda 2003

Not about adverse events

Vissers 2004

Not about adverse events

Figures and Tables -
Table 25. Excluded studies of adverse events
Table 26. Included studies of compliance

Study

Methods

Participants

Interventions

Outcomes (compliance

Summary findings

Notes

Allocation concealment

Balkrishnan 2003

DESIGN: uncontrolled study
patient delivery
ALLOCATION: non‐random
Method of randomisation: NA
Concealment: NA
BLINDING: single‐blind (participants unaware of electronic compliance assessment)
WITHDRAWAL/DROPOUT: described

N: 10
TD: 1 wk; FU: 1 wk
LF: 0 (0%)
BC: NA
Age: NR
Gender (per cent men): NR
Severity: NR
INCLUSION CRITERIA: participants with psoriasis who already enrolling in a study with salicylic acid and topical tacrolimus ointment (Protopic) combination therapy.
EXCLUSION CRITERIA: NR

Topical salicylic acid 6%

No control

Medication adherence:
(1) MEMS cap: medication bottle cap with microprocessor to record time/date of every opening of the bottle.
(2) Patient log (self report) of compliance
Mean adherence rate: method 1: 67% (32% SD); method 2: 92% (7% SD)

Medication adherence measured by method 1 (electronic) much lower than by method 2 (patient log)

Sponsorship not reported

D

Carroll 2004a; Carroll 2004b;
Carroll 2005

DESIGN: within‐patient
patient delivery
ALLOCATION: random
Method of randomisation: NR
Concealment: unclear
BLINDING:
Single‐blind (participants unaware of electronic compliance assessment)
WITHDRAWAL/DROPOUT:
described

N: 30
TD: 8 wks; FU: 12 wks
LF: 6 (20%)
BC: Yes
Age: 43.6 (range 18 to 70)
Gender (per cent men): 50%
Severity: TSS (0 to 8): 5.3
INCLUSION CRITERIA: participants aged ≥18; symmetrical plaque‐type psoriasis; BSA < = 10%; symmetrical target plaque 1cm² with each with a score of at least 1 for erythema, thickness, and scale
EXCLUSION CRITERIA: pregnancy or risk thereof; topical treatment within previous 2 wks; phototherapy or systemic therapy within previous 4 wks

Topical salicylic acid 6% plus 0.1% tacrolimus ointment BD

Topical salicylic acid 6% plus placebo BD

Medication adherence:
(1) MEMS cap: medication bottle cap with microprocessor to record time/date of every opening of the bottle.
(2) Patient log (self report) of compliance
(3) medication weights

Adherence decreased over time. On the intervention side, a decrease in adherence rate of 10% was associated with a 1‐point increase in severity (P < 0.05). For the placebo‐treated side, adherence was not significantly correlated with changes in severity.

Poor compliance appears to have an impact on treatment outcomes in psoriasis

Mean adherence (method 1):
% (doses taken/doses expected): 55%;
% (days with twice‐daily dose/total days): 39.1% Higher adherence rate for women and older participants

Sponsored by Fujisawa Healthcare, Inc. and by Wake Forest University School of Medicine.

Excluded from effectiveness review (comparator is not placebo)

B

Feldman 2007

DESIGN: uncontrolled study
patient delivery
ALLOCATION: non‐random
Method of randomisation: NA
Concealment: NA
BLINDING: single‐blind (participants unaware of electronic compliance assessment)
WITHDRAWAL/DROPOUT:
described

N: 29
TD: 8 wks; FU: 8 wks
LF: NR
BC: NA
Age: 43.5
Gender (per cent men): NR
Severity: NR
INCLUSION CRITERIA: NR
EXCLUSION CRITERIA: NR

6% salicylic acid gel BD

No control

Impact of office visits on participants' adherence to topical treatment.

Adherence assessed using MEMS cap: medication bottle cap

Adherence statistically significantly higher at time of office visit.

Mean adherence over the study duration was 55%.

Mean applications/day: 1.1 (range: 0.72 to 1.4)

Sponsored in part by Astellas Pharma US, Inc.
The Center for Dermatology Research is funded by a grant from GaldermaLaboratories, LP.

(see also Balkrishnan 2003; Carroll 2004a, 2004b, 2005)

D

Ferrandiz 1998

DESIGN: between‐patient
patient delivery (therapy)
Clinician delivery (programme)
ALLOCATION: random
Method of randomisation: NR
Concealment: unclear
BLINDING: open
WITHDRAWAL/DROPOUT: described

N: 881
TD: 16 wks; FU: 16 wks
LF: 127 (12.6%)
BC: Yes
Age: 43.3 (16.9SD)
Gender (per cent men): NR
Severity: mean PASI: 7.0
INCLUSION CRITERIA: moderately severe chronic plaque psoriasis; BSA < = 30%; aged 18 to 70; under specialist supervision
EXCLUSION CRITERIA: pregnancy or lactation; history of intolerance to calcipotriol/excipients; concurrent vitamin D (> 400 units/day) or calcium tablets; psoriasis mainly on face or hirsute areas

Calcipotriol plus reinforcement programme

Calcipotriol without reinforcement programme

Reinforcement therapeutic programme to enhance adherence: dermatologist provided participant education with explanation of disease characteristics and treatment efficacy and application, plus written information card

The reinforcement programme had no effect on treatment efficacy

Sponsorship not reported

B

Fouere 2005

DESIGN: questionnaire survey (observational cross‐sectional study)
ALLOCATION: non‐random
Method of randomisation: NA
Concealment: NA
BLINDING: open
WITHDRAWAL/DROPOUT:
response rate not reported

N: 1281
TD: NA; FU: NA
LF: NA
BC: NA
Age: 51.9 (SD 14.8)
Gender (per cent men): 48%
Severity: 74% considered their psoriasis as at least moderately severe
INCLUSION CRITERIA: members of the national psoriasis patient associations in France, UK, Belgium, Germany, and the Netherlands.
EXCLUSION CRITERIA: not stated

Any antipsoriatic therapy

Compliance measured against PMAQ‐3w scale (patient medication adherence questionnaire): strict adherence to prescribed regimen over previous 3 days and last weekend

Reasons for non‐compliance

Perceived necessary measures to increase compliance

73% reported non‐compliance with current treatment

Main reasons for non‐compliance: lack of efficacy, messiness, and time constraints

To improve compliance, patients suggested improved efficacy, less greasy, sticky and smelly treatment, and fewer side‐effects.

Sponsorship not reported.

70% of responders used topical therapy

D

Gokdemir 2008

DESIGN: open uncontrolled study
patient delivery
ALLOCATION: non‐random
Method of randomisation: NA
Concealment: NA
BLINDING: open WITHDRAWAL/DROPOUT: described

N: 109
TD: 8 wks; FU: 8 wks
LF: 6 (6%)
BC: NA
Age: 40 (range: 16 to 70)
Gender (per cent men): 43%
Severity: PASI: 9.1 (range: 1.2 to 35)
INCLUSION CRITERIA: chronic plaque psoriasis; received prescribed antipsoriatic therapy; aged ≥16; attending outpatient clinic in Istanbul.
EXCLUSION CRITERIA: other types of psoriasis; hospitalised; pregnancy

Any prescribed antipsoriatic therapy

Medication adherence: number prescribed doses taken/number prescribed doses prescribed (see Zaghloul 2004).

Mean adherence for topical therapy: 72% (31%SD)

Adherence rate was correlated with being unmarried, more highly educated, and being satisfied with treatment

Main reasons for non‐adherence were busyness and 'being fed up'

Findings relate to any treatment for psoriasis (not just topical therapy)

Sponsorship not reported

D

Richards 1999

DESIGN: questionnaire survey (cross‐sectional uncontrolled study)
patient delivery
ALLOCATION: non‐random
Method of randomisation: NA
Concealment: NA
BLINDING: open WITHDRAWAL/DROPOUT: Response rate not reported

N: 120
TD: NA; FU: NA
LF: NA
BC: NA
Age: 49 (18 to 84)
Gender (per cent men): 54%
Severity: Duration: range: 1 to 63 yrs
INCLUSION CRITERIA: consecutive participants attending tertiary psoriasis specialty clinic; psoriasis.
EXCLUSION CRITERIA: not stated

Any antipsoriatic therapy

Per cent complying with treatment (self report): scale not reported

39 per cent reported non‐compliance (sometimes/never complying) with prescribed treatment. The non‐compliant group had a higher self‐rated disease severity, were younger, and had a younger age at onset.
The non‐compliant group reported that psoriasis had a greater impact on daily life

Factors affecting compliance included the doctor‐participant relationship; optimism with the treatment prescribed; and a limited 'nuisance' value of treatment in terms of side‐effects and hassle of use

Sponsorship not reported

55% of participants were using topical therapies

D

van de Kerkhof 1998

DESIGN: questionnaire survey (uncontrolled study)
patient delivery
ALLOCATION: non‐random
Method of randomisation: NA
Concealment: NA

BLINDING: NA
WITHDRAWAL/DROPOUT: Response rate reported

N: 972
TD: NA; FU: NA
Response rate: 13%
BC: NA
Age: 45.8 (range: 5 to 87)
Gender (per cent men): 43%
Severity: duration of psoriasis > 10 yrs in 67% of responders
INCLUSION CRITERIA: subscribers to 'Psoriasis', the journal of the Dutch Psoriasis Patient Organisation
EXCLUSION CRITERIA: none stated

Any topical antipsoriatic therapy

Per cent complying with frequency of application of prescribed topical therapies

Reason for non‐compliance

29% of responders reported that the prescriber did not specify dosage frequency.
Where dosage frequency was specified, 33% (39%) complied with twice (once) daily regimens

Main reasons for non‐adherence were preference for less frequent dosage; greasiness; lack of efficacy; and higher‐than expected efficacy

Sponsorship not reported.

14‐item questionnaire mailed in 1996 to 6100 subscribers of Psoriasis, the Journal of the Dutch Psoriasis Patient Organisation

Responders asked to report on compliance over past 6 mths

D

van de Kerkhof 2000

DESIGN: questionnaire survey (uncontrolled study)
ALLOCATION: non‐random
Method of randomisation: NA
Concealment: NA
BLINDING: single‐blind
WITHDRAWAL/DROPOUT:
response rate reported

N: 839
TD: NA; FU: NA
LF: NA
Response rate: 14%
BC: NA
Age: 48.5 (range: 4 to 91)
Gender (per cent men): 46%
Severity: duration of psoriasis ≥ 11 years in 62% of responders

INCLUSION CRITERIA: subscribers to 'Psoriasis', the Journal of the Dutch Psoriasis Patient Organisation
EXCLUSION CRITERIA: none stated

Any antipsoriatic therapy including topical treatments, photo(chemo)therapy and systemic therapy

Per cent complying with duration of prescribed treatment (topical therapies)

Per cent complying with frequency of application of prescribed treatment (topical therapies)

Reason for non‐compliance

Per cent complying with duration of prescribed treatment (topical therapies): 71%

Per cent complying with frequency of application of prescribed treatment (topical therapies): 51%

Main reasons for non‐adherence were preference for minimum dosage; time constraints; and lack of confidence in efficacy

Sponsorship not reported

41‐item questionnaire mailed to 6100 subscribers of Psoriasis, the Journal of the Dutch Psoriasis Patient Organisation

Responders asked to report on compliance over past 6 mths

D

van de Kerkhof 2001

DESIGN: within‐patient (see Notes)
patient delivery
ALLOCATION: non‐random
Method of randomisation: NA
concealment: NA
BLINDING: open
WITHDRAWAL/DROPOUT:
described

N: 976
TD: 8 wks; FU: 8 wks
LF: 93 (9.5%)
BC: NR
Age: 45.6 (range: 7.4 to 88.4)
Gender (per cent men): 52% Severity: BSA ≥ 10% in 51% of participants

INCLUSION CRITERIA: psoriasis (type NR); eligible for treatment with calcipotriol

EXCLUSION CRITERIA:
concomitant topical or systemic antipsoriatic therapy; co‐existing skin disorder other than psoriasis

Calcipotriol cream OM plus calcipotriol ointment ON

Calcipotriol ointment BD

Compliance:
self‐reported number of days cream/ointment regimen applied

At wk 3, 72% of participants applied the regimen on most days. By wk 8, this statistic had fallen to 61%

51% of the 309 participants with previous experience of calcipotriol ointment monotherapy reported that their compliance with the cream/ointment regimen was higher

Sponsorship not reported

Control group comprised retrospective self‐reported experience of calcipotriol ointment monotherapy by 35% of participants in the intervention group

D

Zaghloul 2004

DESIGN: uncontrolled study
patient delivery
ALLOCATION: non‐random
Method of randomisation: NA
Concealment: NA
BLINDING: single‐blind (participants unaware that study focused on compliance)
WITHDRAWAL/DROPOUT:
described

N: 294
TD: 12 wks; FU: 12 wks
LF: 93 (31.6%)
BC: NA
Age: 45.1 (range: 20 to 65)
Gender (per cent men): 44.3%
Severity: NR
INCLUSION CRITERIA: psoriasis (unclear if chronic plaque only); aged 18 to 65; prescribed oral, topical or combined treatment
EXCLUSION CRITERIA: pregnancy, lactation, concomitant disease

Topical, oral, or combined antipsoriatic medication

No control

Medication adherence:
(1) number prescribed doses taken/number prescribed doses prescribed
(2) patient self‐report

Quality of Life (DLQI) (0 to 30; higher score implies lower quality of life)

Medication adherence measured by method 1 (objective) much lower than by method 2 (patient self report). Mean rate: 60.6% (33.0%SD); (range: 0% to169%)

Direct correlation observed between medication adherence and quality of life

Adherence rate higher for participants who were women, married, employed, or not paying for prescriptions

Adherence greater for topical (vs. systemic) therapy, once daily, or first‐time use

Authors report no relevant financial interests

D

per cent men: per cent male; AE(L): number local adverse events/number participants; AE(S): number systemic adverse events/number participants; AE: adverse events; BC: baseline comparability; BD: twice daily; BSA: body surface area; FU: follow up (includes TD); N: number enrolled; NA: not applicable; NR: not reported; OD: once daily; PASI: Psoriasis Area and Severity Index; PRN: as required; TD: treatment duration; TSS: Total Severity Score; WA: withdrawal due to adverse events

Figures and Tables -
Table 26. Included studies of compliance
Table 27. Excluded studies of compliance

Study

Reason for exclusion

Atkinson 2004

Adherence not assessed

Chu 2000

Treatment guideline (not primary study)

Gupta 2007

Review/think piece

Lee 2006

Review

Osborne 2002

Study focused on non‐responsive participants rather than those that are specifically non‐compliant

Richards 2006

Review

Szeimies 2004

Think piece (not primary study)

Figures and Tables -
Table 27. Excluded studies of compliance
Comparison 1. Vitamin D analogues versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 IAGI Show forest plot

20

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 Calcipotriol

10

2287

Std. Mean Difference (IV, Random, 95% CI)

‐0.93 [‐1.17, ‐0.68]

1.2 Calcipotriol plus occlusion

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 Calcitriol

6

1120

Std. Mean Difference (IV, Random, 95% CI)

‐1.03 [‐1.71, ‐0.36]

1.4 Tacalcitol

2

433

Std. Mean Difference (IV, Random, 95% CI)

‐0.84 [‐1.41, ‐0.26]

1.5 Maxacalcitol

1

103

Std. Mean Difference (IV, Random, 95% CI)

‐1.43 [‐1.91, ‐0.96]

1.6 Paricalcitol OD

1

22

Std. Mean Difference (IV, Random, 95% CI)

‐1.66 [‐2.66, ‐0.67]

1.7 Becocalcidiol OD

1

121

Std. Mean Difference (IV, Random, 95% CI)

‐0.22 [‐0.58, 0.14]

1.8 Becocalcidiol twice daily

1

119

Std. Mean Difference (IV, Random, 95% CI)

‐0.67 [‐1.04, ‐0.30]

2 TSS Show forest plot

19

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

2.1 Calcipotriol

10

1208

Std. Mean Difference (IV, Random, 95% CI)

‐1.15 [‐1.41, ‐0.89]

2.2 Calcipotriol plus occlusion

1

187

Std. Mean Difference (IV, Random, 95% CI)

‐0.15 [‐0.44, 0.14]

2.3 Calcitriol

4

1027

Std. Mean Difference (IV, Random, 95% CI)

‐1.22 [‐2.38, ‐0.07]

2.4 Tacalcitol

3

496

Std. Mean Difference (IV, Random, 95% CI)

‐0.66 [‐0.95, ‐0.36]

2.5 Maxacalcitol

1

103

Std. Mean Difference (IV, Random, 95% CI)

‐1.61 [‐2.10, ‐1.12]

2.6 Paricalcitol OD

1

22

Std. Mean Difference (IV, Random, 95% CI)

‐2.15 [‐3.24, ‐1.06]

2.7 Becocalcidiol OD

1

121

Std. Mean Difference (IV, Random, 95% CI)

‐0.02 [‐0.37, 0.34]

2.8 Becocalcidiol twice daily

1

119

Std. Mean Difference (IV, Random, 95% CI)

‐0.46 [‐0.83, ‐0.10]

3 PASI Show forest plot

9

2422

Std. Mean Difference (IV, Random, 95% CI)

‐0.58 [‐0.71, ‐0.45]

3.1 Calcipotriol

8

2195

Std. Mean Difference (IV, Random, 95% CI)

‐0.65 [‐0.75, ‐0.55]

3.2 Calcipotriol plus occlusion

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.3 Calcitriol

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.4 Tacalcitol

1

227

Std. Mean Difference (IV, Random, 95% CI)

‐0.27 [‐0.56, 0.03]

3.5 Maxacalcitol

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.6 Paricalcitol OD

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.7 Becocalcidiol OD

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.8 Becocalcidiol twice daily

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4 PAGI Show forest plot

5

1467

Std. Mean Difference (IV, Random, 95% CI)

‐0.54 [‐0.72, ‐0.36]

4.1 Calcipotriol

2

439

Std. Mean Difference (IV, Random, 95% CI)

‐0.64 [‐0.97, ‐0.30]

4.2 Calcipotriol plus occlusion

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.3 Calcitriol

2

801

Std. Mean Difference (IV, Random, 95% CI)

‐0.59 [‐0.76, ‐0.41]

4.4 Tacalcitol

1

227

Std. Mean Difference (IV, Random, 95% CI)

‐0.24 [‐0.53, 0.05]

4.5 Maxacalcitol

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.6 Paricalcitol OD

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.7 Becocalcidiol OD

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.8 Becocalcidiol twice daily

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5 Combined end point (IAGI/TSS/PASI/PAGI) Show forest plot

30

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

5.1 Calcipotriol

17

3269

Std. Mean Difference (IV, Random, 95% CI)

‐0.96 [‐1.15, ‐0.77]

5.2 Calcipotriol plus occlusion

1

187

Std. Mean Difference (IV, Random, 95% CI)

‐0.15 [‐0.44, 0.14]

5.3 Calcitriol

7

1140

Std. Mean Difference (IV, Random, 95% CI)

‐0.92 [‐1.54, ‐0.29]

5.4 Tacalcitol

4

723

Std. Mean Difference (IV, Random, 95% CI)

‐0.73 [‐1.09, ‐0.37]

5.5 Maxacalcitol

1

103

Std. Mean Difference (IV, Random, 95% CI)

‐1.43 [‐1.91, ‐0.96]

5.6 Paricalcitol OD

1

22

Std. Mean Difference (IV, Random, 95% CI)

‐1.66 [‐2.66, ‐0.67]

5.7 Becocalcidiol OD

1

121

Std. Mean Difference (IV, Random, 95% CI)

‐0.22 [‐0.58, 0.14]

5.8 Becocalcidiol twice daily

1

119

Std. Mean Difference (IV, Random, 95% CI)

‐0.67 [‐1.04, ‐0.30]

6 Total withdrawals Show forest plot

25

4715

Risk Difference (M‐H, Random, 95% CI)

‐0.02 [‐0.05, 0.00]

6.1 Calcipotriol

14

3132

Risk Difference (M‐H, Random, 95% CI)

‐0.03 [‐0.06, 0.00]

6.2 Calcipotriol plus occlusion

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.3 Calcitriol

5

339

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.02, 0.02]

6.4 Tacalcitol

4

857

Risk Difference (M‐H, Random, 95% CI)

‐0.05 [‐0.14, 0.05]

6.5 Maxacalcitol

1

120

Risk Difference (M‐H, Random, 95% CI)

0.11 [‐0.01, 0.23]

6.6 Paricalcitol OD

1

22

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.16, 0.16]

6.7 Becocalcidiol OD

1

124

Risk Difference (M‐H, Random, 95% CI)

‐0.01 [‐0.12, 0.11]

6.8 Becocalcidiol twice daily

1

121

Risk Difference (M‐H, Random, 95% CI)

‐0.01 [‐0.13, 0.10]

7 Withdrawals due to adverse events Show forest plot

23

4463

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.02, 0.01]

7.1 Calcipotriol

12

2880

Risk Difference (M‐H, Random, 95% CI)

‐0.02 [‐0.04, 0.00]

7.2 Calcipotriol plus occlusion

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.3 Calcitriol

5

339

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.02, 0.02]

7.4 Tacalcitol

4

857

Risk Difference (M‐H, Random, 95% CI)

0.00 [‐0.01, 0.02]

7.5 Maxacalcitol

1

120

Risk Difference (M‐H, Random, 95% CI)

‐0.01 [‐0.08, 0.06]

7.6 Paricalcitol OD

1

22

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.16, 0.16]

7.7 Becocalcidiol OD

1

124

Risk Difference (M‐H, Random, 95% CI)

0.03 [‐0.02, 0.08]

7.8 Becocalcidiol twice daily

1

121

Risk Difference (M‐H, Random, 95% CI)

0.05 [‐0.01, 0.11]

8 Withdrawals due to treatment failure Show forest plot

14

2752

Risk Difference (M‐H, Random, 95% CI)

‐0.03 [‐0.05, 0.00]

8.1 Calcipotriol

7

1770

Risk Difference (M‐H, Random, 95% CI)

‐0.03 [‐0.08, 0.01]

8.2 Calcipotriol plus occlusion

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.3 Calcitriol

4

281

Risk Difference (M‐H, Random, 95% CI)

‐0.03 [‐0.12, 0.05]

8.4 Tacalcitol

1

314

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.01, 0.01]

8.5 Maxacalcitol

1

120

Risk Difference (M‐H, Random, 95% CI)

‐0.03 [‐0.11, 0.04]

8.6 Paricalcitol OD

1

22

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.16, 0.16]

8.7 Becocalcidiol OD

1

124

Risk Difference (M‐H, Random, 95% CI)

‐0.02 [‐0.07, 0.04]

8.8 Becocalcidiol twice daily

1

121

Risk Difference (M‐H, Random, 95% CI)

‐0.03 [‐0.09, 0.02]

9 Adverse events (local) Show forest plot

19

4402

Risk Difference (M‐H, Random, 95% CI)

0.00 [‐0.01, 0.02]

9.1 Calcipotriol

11

2652

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.03, 0.05]

9.2 Calcipotriol plus occlusion

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.3 Calcitriol

4

917

Risk Difference (M‐H, Random, 95% CI)

‐0.01 [‐0.03, 0.02]

9.4 Tacalcitol

2

566

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.03, 0.03]

9.5 Maxacalcitol

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.6 Paricalcitol OD

1

22

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.16, 0.16]

9.7 Becocalcidiol OD

1

124

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.06, 0.08]

9.8 Becocalcidiol twice daily

1

121

Risk Difference (M‐H, Random, 95% CI)

0.10 [0.00, 0.19]

10 Adverse events (systemic) Show forest plot

14

2463

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.01, 0.01]

10.1 Calcipotriol

8

1182

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.01, 0.01]

10.2 Calcipotriol plus occlusion

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.3 Calcitriol

3

647

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.01, 0.01]

10.4 Tacalcitol

1

244

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.02, 0.02]

10.5 Maxacalcitol

1

120

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.05, 0.05]

10.6 Paricalcitol OD

1

22

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.16, 0.16]

10.7 Becocalcidiol OD

1

124

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.03, 0.03]

10.8 Becocalcidiol twice daily

1

124

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.03, 0.03]

Figures and Tables -
Comparison 1. Vitamin D analogues versus placebo
Comparison 2. Corticosteroid (potent) versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 IAGI Show forest plot

11

1904

Std. Mean Difference (IV, Random, 95% CI)

1.00 [‐1.18, ‐0.82]

1.1 Betamethasone dipropionate OD

2

739

Std. Mean Difference (IV, Random, 95% CI)

‐0.81 [‐0.98, ‐0.64]

1.2 Betamethasone dipropionate twice daily

4

537

Std. Mean Difference (IV, Random, 95% CI)

‐1.35 [‐1.56, ‐1.15]

1.3 Betamethasone dipropionate, maintenance

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.4 Betamethasone valerate

1

74

Std. Mean Difference (IV, Random, 95% CI)

‐1.41 [‐1.92, ‐0.90]

1.5 Budesonide

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.6 Desonide

1

76

Std. Mean Difference (IV, Random, 95% CI)

‐0.81 [‐1.34, ‐0.28]

1.7 Diflorasone diacetate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.8 Fluticasone propionate

2

383

Std. Mean Difference (IV, Random, 95% CI)

‐0.93 [‐1.14, ‐0.72]

1.9 Hydrocortisone buteprate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.10 Mometasone furoate

1

95

Std. Mean Difference (IV, Random, 95% CI)

‐0.75 [‐1.17, ‐0.34]

2 TSS Show forest plot

7

611

Std. Mean Difference (IV, Random, 95% CI)

‐0.77 [‐1.01, ‐0.52]

2.1 Betamethasone dipropionate OD

1

93

Std. Mean Difference (IV, Random, 95% CI)

‐0.74 [‐1.16, ‐0.32]

2.2 Betamethasone dipropionate twice daily

1

33

Std. Mean Difference (IV, Random, 95% CI)

‐0.77 [‐1.48, ‐0.06]

2.3 Betamethasone dipropionate, maintenance

1

38

Std. Mean Difference (IV, Random, 95% CI)

‐0.95 [‐1.62, ‐0.27]

2.4 Betamethasone valerate

1

22

Std. Mean Difference (IV, Random, 95% CI)

‐1.09 [‐2.00, ‐0.18]

2.5 Budesonide

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.6 Desonide

1

76

Std. Mean Difference (IV, Random, 95% CI)

‐1.16 [‐1.70, ‐0.61]

2.7 Diflorasone diacetate

1

93

Std. Mean Difference (IV, Random, 95% CI)

‐0.32 [‐0.73, 0.09]

2.8 Fluticasone propionate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.9 Hydrocortisone buteprate

1

161

Std. Mean Difference (IV, Random, 95% CI)

‐0.46 [‐0.77, ‐0.15]

2.10 Mometasone furoate

1

95

Std. Mean Difference (IV, Random, 95% CI)

‐1.12 [‐1.55, ‐0.68]

3 PASI Show forest plot

3

1158

Std. Mean Difference (IV, Random, 95% CI)

‐0.97 [‐1.31, ‐0.62]

3.1 Betamethasone dipropionate OD

2

739

Std. Mean Difference (IV, Random, 95% CI)

‐0.79 [‐1.44, ‐0.14]

3.2 Betamethasone dipropionate twice daily

1

419

Std. Mean Difference (IV, Random, 95% CI)

‐1.21 [‐1.44, ‐0.97]

3.3 Betamethasone dipropionate, maintenance

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.4 Betamethasone valerate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.5 Budesonide

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.6 Desonide

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.7 Diflorasone diacetate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.8 Fluticasone propionate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.9 Hydrocortisone buteprate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.10 Mometasone furoate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4 PAGI

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.1 Betamethasone dipropionate OD

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.2 Betamethasone dipropionate twice daily

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.3 Betamethasone dipropionate, maintenance

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.4 Betamethasone valerate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.5 Budesonide

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.6 Desonide

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.7 Diflorasone diacetate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.8 Fluticasone propionate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.9 Hydrocortisone buteprate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.10 Mometasone furoate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5 Combined end point (IAGI/TSS/PASI/PAGI) Show forest plot

15

2311

Std. Mean Difference (IV, Random, 95% CI)

‐0.89 [‐1.06, ‐0.72]

5.1 Betamethasone dipropionate OD

3

832

Std. Mean Difference (IV, Random, 95% CI)

‐0.80 [‐0.96, ‐0.64]

5.2 Betamethasone dipropionate twice daily

4

537

Std. Mean Difference (IV, Random, 95% CI)

‐1.35 [‐1.56, ‐1.15]

5.3 Betamethasone dipropionate, maintenance

1

38

Std. Mean Difference (IV, Random, 95% CI)

‐0.95 [‐1.62, ‐0.27]

5.4 Betamethasone valerate

2

96

Std. Mean Difference (IV, Random, 95% CI)

‐1.33 [‐1.78, ‐0.89]

5.5 Budesonide

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5.6 Desonide

1

76

Std. Mean Difference (IV, Random, 95% CI)

‐0.81 [‐1.34, ‐0.28]

5.7 Diflorasone diacetate

1

93

Std. Mean Difference (IV, Random, 95% CI)

‐0.32 [‐0.73, 0.09]

5.8 Fluticasone propionate

2

383

Std. Mean Difference (IV, Random, 95% CI)

‐0.93 [‐1.14, ‐0.72]

5.9 Hydrocortisone buteprate

1

161

Std. Mean Difference (IV, Random, 95% CI)

‐0.46 [‐0.77, ‐0.15]

5.10 Mometasone furoate

1

95

Std. Mean Difference (IV, Random, 95% CI)

‐0.75 [‐1.17, ‐0.34]

6 Total withdrawals Show forest plot

9

1673

Risk Difference (M‐H, Random, 95% CI)

‐0.14 [‐0.22, ‐0.05]

6.1 Betamethasone dipropionate OD

2

756

Risk Difference (M‐H, Random, 95% CI)

‐0.16 [‐0.28, ‐0.04]

6.2 Betamethasone dipropionate twice daily

1

421

Risk Difference (M‐H, Random, 95% CI)

‐0.06 [‐0.12, 0.01]

6.3 Betamethasone dipropionate, maintenance

2

134

Risk Difference (M‐H, Random, 95% CI)

‐0.45 [‐0.60, ‐0.30]

6.4 Betamethasone valerate

1

80

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.12, 0.12]

6.5 Budesonide

1

22

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.16, 0.16]

6.6 Desonide

1

80

Risk Difference (M‐H, Random, 95% CI)

‐0.18 [‐0.38, 0.02]

6.7 Diflorasone diacetate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.8 Fluticasone propionate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.9 Hydrocortisone buteprate

1

180

Risk Difference (M‐H, Random, 95% CI)

0.00 [‐0.09, 0.10]

6.10 Mometasone furoate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7 Withdrawals due to adverse events Show forest plot

9

1292

Risk Difference (M‐H, Random, 95% CI)

‐0.01 [‐0.05, 0.02]

7.1 Betamethasone dipropionate OD

1

633

Risk Difference (M‐H, Random, 95% CI)

‐0.07 [‐0.11, ‐0.02]

7.2 Betamethasone dipropionate twice daily

1

33

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.11, 0.11]

7.3 Betamethasone dipropionate, maintenance

2

134

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.04, 0.04]

7.4 Betamethasone valerate

1

80

Risk Difference (M‐H, Random, 95% CI)

0.08 [‐0.02, 0.17]

7.5 Budesonide

1

22

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.16, 0.16]

7.6 Desonide

1

80

Risk Difference (M‐H, Random, 95% CI)

‐0.1 [‐0.24, 0.04]

7.7 Diflorasone diacetate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.8 Fluticasone propionate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.9 Hydrocortisone buteprate

1

190

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.02, 0.04]

7.10 Mometasone furoate

1

120

Risk Difference (M‐H, Random, 95% CI)

‐0.05 [‐0.11, 0.01]

8 Withdrawals due to treatment failure Show forest plot

6

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

8.1 Betamethasone dipropionate OD

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.2 Betamethasone dipropionate twice daily

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.3 Betamethasone dipropionate, maintenance

2

130

Risk Difference (M‐H, Random, 95% CI)

‐0.46 [‐0.61, ‐0.31]

8.4 Betamethasone valerate

1

80

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.05, 0.05]

8.5 Budesonide

1

22

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.16, 0.16]

8.6 Desonide

1

80

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.07, 0.07]

8.7 Diflorasone diacetate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.8 Fluticasone propionate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.9 Hydrocortisone buteprate

1

190

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.02, 0.02]

8.10 Mometasone furoate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9 Adverse events (local) Show forest plot

10

2117

Risk Difference (M‐H, Random, 95% CI)

‐0.04 [‐0.08, ‐0.00]

9.1 Betamethasone dipropionate OD

2

756

Risk Difference (M‐H, Random, 95% CI)

‐0.10 [‐0.15, ‐0.04]

9.2 Betamethasone dipropionate twice daily

2

454

Risk Difference (M‐H, Random, 95% CI)

‐0.05 [‐0.12, 0.03]

9.3 Betamethasone dipropionate, maintenance

2

134

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.04, 0.04]

9.4 Betamethasone valerate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.5 Budesonide

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.6 Desonide

1

80

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.11, 0.11]

9.7 Diflorasone diacetate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.8 Fluticasone propionate

1

383

Risk Difference (M‐H, Random, 95% CI)

0.00 [‐0.05, 0.05]

9.9 Hydrocortisone buteprate

1

190

Risk Difference (M‐H, Random, 95% CI)

‐0.06 [‐0.18, 0.07]

9.10 Mometasone furoate

1

120

Risk Difference (M‐H, Random, 95% CI)

‐0.10 [‐0.23, 0.02]

10 Adverse events (systemic) Show forest plot

4

675

Risk Difference (M‐H, Random, 95% CI)

0.00 [‐0.01, 0.01]

10.1 Betamethasone dipropionate OD

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.2 Betamethasone dipropionate twice daily

1

421

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.01, 0.01]

10.3 Betamethasone dipropionate, maintenance

2

134

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.07, 0.10]

10.4 Budesonide

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.5 Desonide

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.6 Diflorasone diacetate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.7 Fluticasone propionate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.8 Hydrocortisone buteprate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.9 Betamethasone valerate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.10 Mometasone furoate

1

120

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.03, 0.03]

Figures and Tables -
Comparison 2. Corticosteroid (potent) versus placebo
Comparison 3. Corticosteroid (very potent) versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 IAGI Show forest plot

5

540

Std. Mean Difference (IV, Random, 95% CI)

‐1.87 [‐2.38, ‐1.36]

1.1 Clobetasol propionate

4

471

Std. Mean Difference (IV, Random, 95% CI)

‐1.89 [‐2.53, ‐1.24]

1.2 Halcinonide

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 Halobetasol

1

69

Std. Mean Difference (IV, Random, 95% CI)

‐1.81 [‐2.37, ‐1.24]

2 TSS Show forest plot

3

545

Std. Mean Difference (IV, Random, 95% CI)

‐1.35 [‐1.80, ‐0.89]

2.1 Clobetasol propionate

3

545

Std. Mean Difference (IV, Random, 95% CI)

‐1.35 [‐1.80, ‐0.89]

2.2 Halcinonide

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.3 Halobetasol

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3 PASI

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.1 Clobetasol propionate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.2 Halcinonide

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.3 Halobetasol

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4 PAGI Show forest plot

3

487

Std. Mean Difference (IV, Random, 95% CI)

‐1.22 [‐1.42, ‐1.02]

4.1 Clobetasol propionate

1

79

Std. Mean Difference (IV, Random, 95% CI)

‐1.01 [‐1.55, ‐0.47]

4.2 Halcinonide

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.3 Halobetasol

2

408

Std. Mean Difference (IV, Random, 95% CI)

‐1.25 [‐1.46, ‐1.04]

5 Combined end point (IAGI/TSS/PASI/PAGI) Show forest plot

10

1493

Std. Mean Difference (IV, Random, 95% CI)

‐1.56 [‐1.87, ‐1.26]

5.1 Clobetasol propionate

7

1016

Std. Mean Difference (IV, Random, 95% CI)

‐1.65 [‐2.10, ‐1.20]

5.2 Halcinonide

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5.3 Halobetasol

3

477

Std. Mean Difference (IV, Random, 95% CI)

‐1.36 [‐1.65, ‐1.07]

6 Total withdrawals Show forest plot

8

1181

Risk Difference (M‐H, Random, 95% CI)

‐0.05 [‐0.10, 0.01]

6.1 Clobetasol propionate

7

1037

Risk Difference (M‐H, Random, 95% CI)

‐0.06 [‐0.13, 0.01]

6.2 Halcinonide

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.3 Halobetasol

1

144

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.03, 0.03]

7 Withdrawals due to adverse events Show forest plot

10

1601

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.01, 0.01]

7.1 Clobetasol propionate

7

1037

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.02, 0.01]

7.2 Halcinonide

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.3 Halobetasol

3

564

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.01, 0.01]

8 Withdrawals due to treatment failure Show forest plot

8

1189

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.02, 0.01]

8.1 Clobetasol propionate

6

845

Risk Difference (M‐H, Random, 95% CI)

‐0.01 [‐0.03, 0.01]

8.2 Halcinonide

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.3 Halobetasol

2

344

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.02, 0.02]

9 Adverse events (local) Show forest plot

8

1265

Risk Difference (M‐H, Random, 95% CI)

0.00 [‐0.02, 0.02]

9.1 Clobetasol propionate

6

845

Risk Difference (M‐H, Random, 95% CI)

0.00 [‐0.03, 0.03]

9.2 Halcinonide

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.3 Halobetasol

2

420

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.02, 0.02]

10 Adverse events (systemic) Show forest plot

6

1056

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.01, 0.01]

10.1 Clobetasol propionate

3

480

Risk Difference (M‐H, Random, 95% CI)

‐0.01 [‐0.02, 0.01]

10.2 Halcinonide

1

156

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.02, 0.02]

10.3 Halobetasol

2

420

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.01, 0.01]

Figures and Tables -
Comparison 3. Corticosteroid (very potent) versus placebo
Comparison 4. Dithranol versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 IAGI

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2 TSS Show forest plot

3

94

Std. Mean Difference (IV, Random, 95% CI)

‐1.06 [‐1.66, ‐0.46]

3 PASI

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4 PAGI

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5 Combined end point (IAGI/TSS/PASI/PAGI) Show forest plot

3

94

Std. Mean Difference (IV, Random, 95% CI)

‐1.06 [‐1.66, ‐0.46]

6 Total withdrawals Show forest plot

4

124

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.09, 0.09]

7 Withdrawals due to adverse events Show forest plot

3

104

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.05, 0.05]

8 Withdrawals due to treatment failure Show forest plot

2

44

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.11, 0.11]

9 Adverse events (local) Show forest plot

3

94

Risk Difference (M‐H, Random, 95% CI)

0.26 [‐0.30, 0.82]

10 Adverse events (systemic) Show forest plot

1

20

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.35, 0.35]

Figures and Tables -
Comparison 4. Dithranol versus placebo
Comparison 5. Vitamin D combination products versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 IAGI Show forest plot

5

2264

Std. Mean Difference (IV, Random, 95% CI)

‐1.44 [‐1.76, ‐1.12]

1.1 Combination calcipotriol/betamethasone dipropionate, once daily

4

1416

Std. Mean Difference (IV, Random, 95% CI)

‐1.21 [‐1.50, ‐0.91]

1.2 Combination calcipotriol/betamethasone dipropionate, twice daily

2

848

Std. Mean Difference (IV, Random, 95% CI)

‐1.90 [‐2.09, ‐1.71]

2 TSS

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.1 Combination calcipotriol/betamethasone dipropionate, once daily

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 Combination calcipotriol/betamethasone dipropionate, twice daily

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3 PASI Show forest plot

5

2263

Std. Mean Difference (IV, Random, 95% CI)

‐1.24 [‐1.53, ‐0.95]

3.1 Combination calcipotriol/betamethasone dipropionate, once daily

4

1414

Std. Mean Difference (IV, Random, 95% CI)

‐1.14 [‐1.57, ‐0.70]

3.2 Combination calcipotriol/betamethasone dipropionate, twice daily

2

849

Std. Mean Difference (IV, Random, 95% CI)

‐1.41 [‐1.86, ‐0.97]

4 PAGI Show forest plot

1

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

4.1 Combination calcipotriol/betamethasone dipropionate, once daily

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.2 Combination calcipotriol/betamethasone dipropionate, twice daily

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5 Combined end point (IAGI/TSS/PASI/PAGI) Show forest plot

5

2264

Std. Mean Difference (IV, Random, 95% CI)

‐1.44 [‐1.76, ‐1.12]

5.1 Combination calcipotriol/betamethasone dipropionate, once daily

4

1416

Std. Mean Difference (IV, Random, 95% CI)

‐1.21 [‐1.50, ‐0.91]

5.2 Combination calcipotriol/betamethasone dipropionate, twice daily

2

848

Std. Mean Difference (IV, Random, 95% CI)

‐1.90 [‐2.09, ‐1.71]

6 Total withdrawals Show forest plot

5

2340

Risk Difference (M‐H, Random, 95% CI)

‐0.12 [‐0.17, ‐0.07]

6.1 Combination calcipotriol/betamethasone dipropionate, once daily

4

1483

Risk Difference (M‐H, Random, 95% CI)

‐0.15 [‐0.22, ‐0.09]

6.2 Combination calcipotriol/betamethasone dipropionate, twice daily

2

857

Risk Difference (M‐H, Random, 95% CI)

‐0.07 [‐0.12, ‐0.03]

7 Withdrawals due to adverse events Show forest plot

3

1723

Risk Difference (M‐H, Random, 95% CI)

‐0.07 [‐0.11, ‐0.04]

7.1 Combination calcipotriol/betamethasone dipropionate, once daily

3

1280

Risk Difference (M‐H, Random, 95% CI)

‐0.07 [‐0.11, ‐0.03]

7.2 Combination calcipotriol/betamethasone dipropionate, twice daily

1

443

Risk Difference (M‐H, Random, 95% CI)

‐0.10 [‐0.14, ‐0.05]

8 Withdrawals due to treatment failure Show forest plot

1

802

Risk Difference (M‐H, Random, 95% CI)

‐0.09 [‐0.12, ‐0.06]

8.1 Combination calcipotriol/betamethasone dipropionate, once daily

1

359

Risk Difference (M‐H, Random, 95% CI)

‐0.09 [‐0.13, ‐0.05]

8.2 Combination calcipotriol/betamethasone dipropionate, twice daily

1

443

Risk Difference (M‐H, Random, 95% CI)

‐0.09 [‐0.13, ‐0.05]

9 Adverse events (local) Show forest plot

5

2334

Risk Difference (M‐H, Random, 95% CI)

‐0.05 [‐0.08, ‐0.02]

9.1 Combination calcipotriol/betamethasone dipropionate, once daily

4

1479

Risk Difference (M‐H, Random, 95% CI)

‐0.07 [‐0.11, ‐0.02]

9.2 Combination calcipotriol/betamethasone dipropionate, twice daily

2

855

Risk Difference (M‐H, Random, 95% CI)

‐0.03 [‐0.08, 0.01]

10 Adverse events (systemic) Show forest plot

1

412

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.01, 0.01]

10.1 Combination calcipotriol/betamethasone dipropionate, once daily

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.2 Combination calcipotriol/betamethasone dipropionate, twice daily

1

412

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.01, 0.01]

Figures and Tables -
Comparison 5. Vitamin D combination products versus placebo
Comparison 6. Other treatment versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 IAGI Show forest plot

8

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

1.1 Aloe vera extract 0.5% hydrophilic cream, three times per day

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 Anti‐IL‐8 monoclonal antibody cream

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 Betamethasone 17‐valerate 21‐acetate plus tretinoin plus salicylic acid

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.4 Caffeine (topical) 10%, TD

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.5 Calcipotriene 0.005% ointment + nicotinamide 0.05% or 0.1% or 0.7% or 1.4%, twice daily

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.6 Dead Sea salts emollient lotion

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.7 Fish oil plus occlusion

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.8 Herbal skin care (Dr Michaels® cleansing gel, ointment and skin conditioner), twice daily

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.9 Hexafluoro‐1,25‐dihydroxyvitamin D3

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.10 Indigo naturalis 1.4% ointment

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.11 Kukui nut oil, TD

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.12 Mahonia aquifolium (Reliéva™), twice daily

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.13 Methotrexate gel

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.14 Mycophenolic acid ointment

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.15 NG‐monomethyl‐L‐arginine (L‐NMMA) cream

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.16 Nicotinamide 1.4%, twice daily

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.17 Oleum horwathiensis (Psoricur®)

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.18 Omega‐3‐polyunsaturated fatty acids ointment

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.19 Platelet aggregation activating factor (PAF)(Ro 24‐0238)

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.20 Polymyxin B cream 200,000 U/g

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.21 PTH (1‐34) in Novasome A® liposomal cream, twice daily

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.22 Sirolimus (topical), 2.2% for 6 wks, then 8% for a further 6 wks

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.23 Tacrolimus ointment

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.24 Tar

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.25 Tazarotene

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.26 Theophylline 1% ointment, twice daily

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2 TSS Show forest plot

17

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

2.1 Aloe vera extract 0.5% hydrophilic cream, three times per day

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 Anti‐IL‐8 monoclonal antibody cream

1

89

Std. Mean Difference (IV, Random, 95% CI)

‐0.70 [‐1.13, ‐0.27]

2.3 Betamethasone 17‐valerate 21‐acetate plus tretinoin plus salicylic acid

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.4 Caffeine (topical) 10%, TD

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.5 Calcipotriene 0.005% ointment + nicotinamide 0.05% or 0.1% or 0.7% or 1.4%, twice daily

1

192

Std. Mean Difference (IV, Random, 95% CI)

‐0.48 [‐0.81, ‐0.15]

2.6 Dead Sea salts emollient lotion

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.7 Fish oil plus occlusion

1

50

Std. Mean Difference (IV, Random, 95% CI)

‐1.05 [‐1.64, ‐0.46]

2.8 Herbal skin care (Dr Michaels® cleansing gel, ointment and skin conditioner), twice daily

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.9 Hexafluoro‐1,25‐dihydroxyvitamin D3, twice daily

1

30

Std. Mean Difference (IV, Random, 95% CI)

‐1.13 [‐1.91, ‐0.35]

2.10 Indigo naturalis 1.4% ointment

2

88

Std. Mean Difference (IV, Random, 95% CI)

‐1.64 [‐2.13, ‐1.15]

2.11 Kukui nut oil, TD

1

24

Std. Mean Difference (IV, Random, 95% CI)

0.33 [‐0.48, 1.14]

2.12 Mahonia aquifolium (Reliéva™), twice daily

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.13 Methotrexate gel

1

82

Std. Mean Difference (IV, Random, 95% CI)

‐0.48 [‐0.92, ‐0.04]

2.14 Mycophenolic acid ointment

1

14

Std. Mean Difference (IV, Random, 95% CI)

‐1.44 [‐2.67, ‐0.22]

2.15 NG‐monomethyl‐L‐arginine (L‐NMMA) cream

1

34

Std. Mean Difference (IV, Random, 95% CI)

0.08 [‐0.60, 0.75]

2.16 Nicotinamide 1.4%, twice daily

1

96

Std. Mean Difference (IV, Random, 95% CI)

‐0.20 [‐0.60, 0.20]

2.17 Oleum horwathiensis (Psoricur®)

1

42

Std. Mean Difference (IV, Random, 95% CI)

‐0.77 [‐1.40, ‐0.14]

2.18 Omega‐3‐polyunsaturated fatty acids ointment

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.19 Platelet aggregation activating factor (PAF)(Ro 24‐0238)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.20 Polymyxin B cream 200,000 U/g

1

30

Std. Mean Difference (IV, Random, 95% CI)

0.13 [‐0.59, 0.85]

2.21 PTH (1‐34) in Novasome A® liposomal cream, twice daily

1

30

Std. Mean Difference (IV, Random, 95% CI)

‐2.31 [‐3.26, ‐1.36]

2.22 Sirolimus (topical), 2.2% for 6 wks, then 8% for a further 6 wks

1

44

Std. Mean Difference (IV, Random, 95% CI)

‐0.39 [‐0.98, 0.21]

2.23 Tacrolimus ointment

1

47

Std. Mean Difference (IV, Random, 95% CI)

0.06 [‐0.52, 0.63]

2.24 Tar

1

36

Std. Mean Difference (IV, Random, 95% CI)

‐0.45 [‐1.11, 0.22]

2.25 Tazarotene

1

318

Std. Mean Difference (IV, Random, 95% CI)

‐0.86 [‐1.11, ‐0.62]

2.26 Theophylline 1% ointment, twice daily

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3 PASI Show forest plot

9

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

3.1 Aloe vera extract 0.5% hydrophilic cream, three times per day

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.2 Anti‐IL‐8 monoclonal antibody cream

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.3 Betamethasone 17‐valerate 21‐acetate plus tretinoin plus salicylic acid

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.4 Caffeine (topical) 10%, TD

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.5 Calcipotriene 0.005% ointment + nicotinamide 0.05% or 0.1% or 0.7% or 1.4%, twice daily

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.6 Dead Sea salts emollient lotion, 30%

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.7 Fish oil plus occlusion

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.8 Herbal skin care (Dr Michaels® cleansing gel, ointment and skin conditioner), twice daily

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.9 Hexafluoro‐1,25‐dihydroxyvitamin D3, twice daily

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.10 Indigo naturalis 1.4% ointment

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.11 Kukui nut oil, twice daily

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.12 Mahonia aquifolium (Reliéva™), twice daily

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.13 Methotrexate gel

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.14 Mycophenolic acid ointment

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.15 NG‐monomethyl‐L‐arginine (L‐NMMA) cream

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.16 Nicotinamide 1.4%, twice daily

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.17 Oleum horwathiensis (Psoricur®)

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.18 Omega‐3‐polyunsaturated fatty acids ointment

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.19 Platelet aggregation activating factor (PAF)(Ro 24‐0238)

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.20 Polymyxin B cream 200,000 U/g

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.21 PTH (1‐34) in Novasome A® liposomal cream, twice daily

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.22 Sirolimus (topical), 2.2% for 6 wks, then 8% for a further 6 wks

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.23 Tacrolimus ointment

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.24 Tar

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.25 Tazarotene

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.26 Theophylline 1% ointment, twice daily

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4 PAGI Show forest plot

2

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

4.1 Aloe vera extract 0.5% hydrophilic cream, three times per day

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.2 Anti‐IL‐8 monoclonal antibody cream

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.3 Betamethasone 17‐valerate 21‐acetate plus tretinoin plus salicylic acid

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.4 Caffeine (topical) 10%, TD

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.5 Calcipotriene 0.005% ointment + nicotinamide 0.05% or 0.1% or 0.7% or 1.4%, twice daily

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.6 Dead Sea salts emollient lotion, 30%

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.7 Fish oil plus occlusion

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.8 Herbal skin care (Dr Michaels® cleansing gel, ointment and skin conditioner), twice daily

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.9 Hexafluoro‐1,25‐dihydroxyvitamin D3, twice daily

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.10 Indigo naturalis 1.4% ointment

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.11 Kukui nut oil, TD

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.12 Mahonia aquifolium (Reliéva™), twice daily

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.13 Methotrexate gel

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.14 Mycophenolic acid ointment

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.15 NG‐monomethyl‐L‐arginine (L‐NMMA) cream

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.16 Nicotinamide 1.4%, twice daily

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.17 Oleum horwathiensis (Psoricur®)

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.18 Omega‐3‐polyunsaturated fatty acids ointment

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.19 Platelet aggregation activating factor (PAF)(Ro 24‐0238)

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.20 Polymyxin B cream 200,000 U/g

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.21 PTH (1‐34) in Novasome A® liposomal cream, twice daily

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.22 Sirolimus (topical), 2.2% for 6 wks, then 8% for a further 6 wks

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.23 Tacrolimus ointment

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.24 Tar

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.25 Tazarotene

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.26 Theophylline 1% ointment, twice daily

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5 Combined end point (IAGI/TSS/PASI/PAGI) Show forest plot

26

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

5.1 Aloe vera extract 0.5% hydrophilic cream, three times per day

1

60

Std. Mean Difference (IV, Random, 95% CI)

‐1.58 [‐2.16, ‐0.99]

5.2 Anti‐IL‐8 monoclonal antibody cream

1

89

Std. Mean Difference (IV, Random, 95% CI)

‐0.59 [‐1.01, ‐0.16]

5.3 Betamethasone 17‐valerate 21‐acetate plus tretinoin plus salicylic acid

1

81

Std. Mean Difference (IV, Random, 95% CI)

‐0.76 [‐1.21, ‐0.31]

5.4 Caffeine (topical) 10%, TD

1

78

Std. Mean Difference (IV, Random, 95% CI)

‐0.39 [‐0.84, 0.06]

5.5 Calcipotriene 0.005% ointment + nicotinamide 0.05% or 0.1% or 0.7% or 1.4%, twice daily

1

192

Std. Mean Difference (IV, Random, 95% CI)

‐0.48 [‐0.81, ‐0.15]

5.6 Dead Sea salts emollient lotion, 30%

1

19

Std. Mean Difference (IV, Random, 95% CI)

0.57 [‐0.36, 1.51]

5.7 Fish oil plus occlusion

1

50

Std. Mean Difference (IV, Random, 95% CI)

‐1.05 [‐1.64, ‐0.46]

5.8 Herbal skin care (Dr Michaels® cleansing gel, ointment and skin conditioner), twice daily

1

24

Std. Mean Difference (IV, Random, 95% CI)

‐2.96 [‐4.19, ‐1.74]

5.9 Hexafluoro‐1,25‐dihydroxyvitamin D3

1

30

Std. Mean Difference (IV, Random, 95% CI)

‐0.62 [‐1.35, 0.12]

5.10 Indigo naturalis 1.4% ointment

2

88

Std. Mean Difference (IV, Random, 95% CI)

‐2.09 [‐2.62, ‐1.56]

5.11 Kukui nut oil, TD

1

24

Std. Mean Difference (IV, Random, 95% CI)

0.0 [‐0.80, 0.80]

5.12 Mahonia aquifolium (Reliéva™), twice daily

1

200

Std. Mean Difference (IV, Random, 95% CI)

‐0.77 [‐1.06, ‐0.48]

5.13 Methotrexate gel

2

142

Std. Mean Difference (IV, Random, 95% CI)

‐1.05 [‐2.04, ‐0.06]

5.14 Mycophenolic acid ointment

1

14

Std. Mean Difference (IV, Random, 95% CI)

‐1.44 [‐2.67, ‐0.22]

5.15 NG‐monomethyl‐L‐arginine (L‐NMMA) cream

1

34

Std. Mean Difference (IV, Random, 95% CI)

0.08 [‐0.60, 0.75]

5.16 Nicotinamide 1.4%, twice daily

1

96

Std. Mean Difference (IV, Random, 95% CI)

‐0.20 [‐0.60, 0.20]

5.17 Oleum horwathiensis (Psoricur®)

1

42

Std. Mean Difference (IV, Random, 95% CI)

‐0.02 [‐0.63, 0.58]

5.18 Omega‐3‐polyunsaturated fatty acids ointment

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5.19 Platelet aggregation activating factor (PAF)(Ro 24‐0238)

1

80

Std. Mean Difference (IV, Random, 95% CI)

‐0.07 [‐0.50, 0.37]

5.20 Polymyxin B cream 200,000 U/g

1

30

Std. Mean Difference (IV, Random, 95% CI)

0.13 [‐0.59, 0.85]

5.21 PTH (1‐34) in Novasome A® liposomal cream, twice daily

1

30

Std. Mean Difference (IV, Random, 95% CI)

‐2.31 [‐3.26, ‐1.36]

5.22 Sirolimus (topical), 2.2% for 6 wks, then 8% for a further 6 wks

1

44

Std. Mean Difference (IV, Random, 95% CI)

‐0.39 [‐0.98, 0.21]

5.23 Tacrolimus ointment

1

47

Std. Mean Difference (IV, Random, 95% CI)

0.06 [‐0.52, 0.63]

5.24 Tar

1

36

Std. Mean Difference (IV, Random, 95% CI)

‐0.45 [‐1.11, 0.22]

5.25 Tazarotene

1

318

Std. Mean Difference (IV, Random, 95% CI)

‐0.86 [‐1.11, ‐0.62]

5.26 Theophylline 1% ointment, twice daily

1

22

Std. Mean Difference (IV, Random, 95% CI)

‐2.87 [‐4.13, ‐1.62]

6 Total withdrawals Show forest plot

23

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

6.1 Aloe vera extract 0.5% hydrophilic cream, three times per day

1

60

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.06, 0.06]

6.2 Anti‐IL‐8 monoclonal antibody cream

1

96

Risk Difference (M‐H, Random, 95% CI)

‐0.02 [‐0.12, 0.08]

6.3 Betamethasone 17‐valerate 21‐acetate plus tretinoin plus salicylic acid

1

85

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.09, 0.09]

6.4 Caffeine (topical) 10%, TD

1

78

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.12, 0.12]

6.5 Calcipotriene 0.005% ointment + nicotinamide 0.05% or 0.1% or 0.7% or 1.4%, twice daily

1

192

Risk Difference (M‐H, Random, 95% CI)

0.03 [‐0.01, 0.08]

6.6 Dead Sea salts emollient lotion

1

24

Risk Difference (M‐H, Random, 95% CI)

0.25 [‐0.06, 0.56]

6.7 Fish oil plus occlusion

1

50

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.07, 0.07]

6.8 Herbal skin care (Dr Michaels® cleansing gel, ointment and skin conditioner), twice daily

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.9 Hexafluoro‐1,25‐dihydroxyvitamin D3

1

30

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.12, 0.12]

6.10 Indigo naturalis 1.4% ointment

2

112

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.15, 0.15]

6.11 Kukui nut oil, TD

1

30

Risk Difference (M‐H, Random, 95% CI)

‐0.13 [‐0.42, 0.15]

6.12 Mahonia aquifolium (Reliéva™), twice daily

1

200

Risk Difference (M‐H, Random, 95% CI)

‐0.23 [‐0.32, ‐0.14]

6.13 Methotrexate gel

1

60

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.06, 0.06]

6.14 Mycophenolic acid ointment

1

14

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.24, 0.24]

6.15 NG‐monomethyl‐L‐arginine (L‐NMMA) cream

1

34

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.11, 0.11]

6.16 Nicotinamide 1.4%, twice daily

1

96

Risk Difference (M‐H, Random, 95% CI)

0.02 [‐0.04, 0.08]

6.17 Oleum horwathiensis

1

50

Risk Difference (M‐H, Random, 95% CI)

0.16 [‐0.04, 0.36]

6.18 Omega‐3‐polyunsaturated fatty acids ointment

1

146

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.15, 0.15]

6.19 Platelet aggregation activating factor (PAF)(Ro 24‐0238)

1

104

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.16, 0.16]

6.20 Polymyxin B cream 200,000 U/g

1

30

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.24, 0.24]

6.21 PTH (1‐34) in Novasome A® liposomal cream, twice daily

1

30

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.12, 0.12]

6.22 Sirolimus (topical)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.23 Tacrolimus ointment

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.24 Tar

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.25 Tazarotene

2

1627

Risk Difference (M‐H, Random, 95% CI)

0.04 [‐0.01, 0.09]

6.26 Theophylline 1% ointment, twice daily

1

22

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.16, 0.16]

7 Withdrawals due to adverse events Show forest plot

19

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

7.1 Aloe vera extract 0.5% hydrophilic cream, three times per day

1

60

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.06, 0.06]

7.2 Anti‐IL‐8 monoclonal antibody cream

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.3 Betamethasone 17‐valerate 21‐acetate plus tretinoin plus salicylic acid

1

85

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.07, 0.06]

7.4 Caffeine (topical) 10%, TD

1

78

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.05, 0.05]

7.5 Calcipotriene 0.005% ointment + nicotinamide 0.05% or 0.1% or 0.7% or 1.4%, twice daily

1

192

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.03, 0.03]

7.6 Dead Sea salts emollient lotion

1

24

Risk Difference (M‐H, Random, 95% CI)

0.08 [‐0.18, 0.35]

7.7 Fish oil plus occlusion

1

50

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.07, 0.07]

7.8 Herbal skin care (Dr Michaels® cleansing gel, ointment and skin conditioner), twice daily

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.9 Hexafluoro‐1,25‐dihydroxyvitamin D3

1

30

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.12, 0.12]

7.10 Indigo naturalis 1.4% ointment

2

112

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.04, 0.04]

7.11 Kukui nut oil, TD

1

30

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.12, 0.12]

7.12 Mahonia aquifolium (Reliéva™), twice daily

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.13 Methotrexate gel

1

60

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.06, 0.06]

7.14 Mycophenolic acid ointment

1

14

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.24, 0.24]

7.15 NG‐monomethyl‐L‐arginine (L‐NMMA) cream

1

34

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.11, 0.11]

7.16 Nicotinamide 1.4%, twice daily

1

96

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.04, 0.04]

7.17 Oleum horwathiensis

1

50

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.07, 0.07]

7.18 Omega‐3‐polyunsaturated fatty acids ointment

1

146

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.03, 0.03]

7.19 Platelet aggregation activating factor (PAF)(Ro 24‐0238)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.20 Polymyxin B cream 200,000 U/g

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.21 PTH (1‐34) in Novasome A® liposomal cream, twice daily

1

30

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.12, 0.12]

7.22 Sirolimus (topical)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.23 Tacrolimus ointment

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.24 Tar

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.25 Tazarotene

2

1627

Risk Difference (M‐H, Random, 95% CI)

0.07 [0.05, 0.10]

7.26 Theophylline 1% ointment, twice daily

1

22

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.16, 0.16]

8 Withdrawals due to treatment failure Show forest plot

18

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

8.1 Aloe vera extract 0.5% hydrophilic cream, three times per day

1

60

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.06, 0.06]

8.2 Anti‐IL‐8 monoclonal antibody cream

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.3 Betamethasone 17‐valerate 21‐acetate plus tretinoin plus salicylic acid

1

85

Risk Difference (M‐H, Random, 95% CI)

0.02 [‐0.04, 0.08]

8.4 Caffeine (topical) 10%, TD

1

78

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.05, 0.05]

8.5 Calcipotriene 0.005% ointment + nicotinamide 0.05% or 0.1% or 0.7% or 1.4%, twice daily

1

192

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.03, 0.03]

8.6 Dead Sea salts emollient lotion

1

24

Risk Difference (M‐H, Random, 95% CI)

0.08 [‐0.12, 0.29]

8.7 Fish oil plus occlusion

1

50

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.07, 0.07]

8.8 Herbal skin care (Dr Michaels® cleansing gel, ointment and skin conditioner), twice daily

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.9 Hexafluoro‐1,25‐dihydroxyvitamin D3

1

30

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.12, 0.12]

8.10 Indigo naturalis 1.4% ointment

1

28

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.13, 0.13]

8.11 Kukui nut oil, TD

1

30

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.12, 0.12]

8.12 Mahonia aquifolium (Reliéva™), twice daily

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.13 Methotrexate gel

1

60

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.06, 0.06]

8.14 Mycophenolic acid ointment

1

14

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.24, 0.24]

8.15 NG‐monomethyl‐L‐arginine (L‐NMMA) cream

1

34

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.11, 0.11]

8.16 Nicotinamide 1.4%, twice daily

1

96

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.04, 0.04]

8.17 Oleum horwathiensis

1

50

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.07, 0.07]

8.18 Omega‐3‐polyunsaturated fatty acids ointment

1

146

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.03, 0.03]

8.19 Platelet aggregation activating factor (PAF)(Ro 24‐0238)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.20 Polymyxin B cream 200,000 U/g

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.21 PTH (1‐34) in Novasome A® liposomal cream, twice daily

1

30

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.12, 0.12]

8.22 Sirolimus (topical)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.23 Tacrolimus ointment

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.24 Tar

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.25 Tazarotene

2

1627

Risk Difference (M‐H, Random, 95% CI)

‐0.02 [‐0.04, 0.01]

8.26 Theophylline 1% ointment, twice daily

1

22

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.16, 0.16]

9 Adverse events (local) Show forest plot

21

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

9.1 Aloe vera extract 0.5% hydrophilic cream, three times per day

1

60

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.06, 0.06]

9.2 Anti‐IL‐8 monoclonal antibody cream

1

92

Risk Difference (M‐H, Random, 95% CI)

0.02 [‐0.10, 0.14]

9.3 Betamethasone 17‐valerate 21‐acetate plus tretinoin plus salicylic acid

1

85

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.07, 0.06]

9.4 Caffeine (topical) 10%, TD

1

78

Risk Difference (M‐H, Random, 95% CI)

0.05 [‐0.03, 0.13]

9.5 Calcipotriene 0.005% ointment + nicotinamide 0.05% or 0.1% or 0.7% or 1.4%, twice daily

1

192

Risk Difference (M‐H, Random, 95% CI)

0.13 [‐0.02, 0.27]

9.6 Dead Sea salts emollient lotion

1

24

Risk Difference (M‐H, Random, 95% CI)

0.08 [‐0.18, 0.35]

9.7 Fish oil plus occlusion

1

50

Risk Difference (M‐H, Random, 95% CI)

0.04 [‐0.06, 0.14]

9.8 Herbal skin care (Dr Michaels® cleansing gel, ointment and skin conditioner), twice daily

1

24

Risk Difference (M‐H, Random, 95% CI)

‐0.09 [‐0.44, 0.27]

9.9 Hexafluoro‐1,25‐dihydroxyvitamin D3

1

30

Risk Difference (M‐H, Random, 95% CI)

0.13 [‐0.06, 0.33]

9.10 Indigo naturalis 1.4% ointment

2

88

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.05, 0.05]

9.11 Kukui nut oil, TD

1

30

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.12, 0.12]

9.12 Mahonia aquifolium (Reliéva™), twice daily

1

200

Risk Difference (M‐H, Random, 95% CI)

‐0.02 [‐0.06, 0.02]

9.13 Methotrexate gel

1

60

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.06, 0.06]

9.14 Mycophenolic acid ointment

1

14

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.24, 0.24]

9.15 NG‐monomethyl‐L‐arginine (L‐NMMA) cream

1

34

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.11, 0.11]

9.16 Nicotinamide 1.4%, twice daily

1

96

Risk Difference (M‐H, Random, 95% CI)

0.10 [‐0.07, 0.28]

9.17 Oleum horwathiensis

1

50

Risk Difference (M‐H, Random, 95% CI)

0.04 [‐0.06, 0.14]

9.18 Omega‐3‐polyunsaturated fatty acids ointment

1

146

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.02, 0.05]

9.19 Platelet aggregation activating factor (PAF)(Ro 24‐0238)

1

104

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.19, 0.19]

9.20 Polymyxin B cream 200,000 U/g

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.21 PTH (1‐34) in Novasome A® liposomal cream, twice daily

1

30

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.12, 0.12]

9.22 Sirolimus (topical)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.23 Tacrolimus ointment

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.24 Tar

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.25 Tazarotene

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.26 Theophylline 1% ointment, twice daily

1

22

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.16, 0.16]

10 Adverse events (systemic) Show forest plot

12

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

10.1 Aloe vera extract 0.5% hydrophilic cream, three times per day

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.2 Anti‐IL‐8 monoclonal antibody cream

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.3 Betamethasone 17‐valerate 21‐acetate plus tretinoin plus salicylic acid

1

85

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.04, 0.04]

10.4 Caffeine (topical) 10%, TD

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.5 Calcipotriene 0.005% ointment + nicotinamide 0.05% or 0.1% or 0.7% or 1.4%, twice daily

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.6 Dead Sea salts emollient lotion

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.7 Fish oil plus occlusion

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.8 Herbal skin care (Dr Michaels® cleansing gel, ointment and skin conditioner), twice daily

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.9 Hexafluoro‐1,25‐dihydroxyvitamin D3

1

30

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.12, 0.12]

10.10 Indigo naturalis 1.4% ointment

2

88

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.05, 0.05]

10.11 Kukui nut oil, TD

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.12 Mahonia aquifolium (Reliéva™), twice daily

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.13 Methotrexate gel

2

166

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.03, 0.03]

10.14 Mycophenolic acid ointment

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.15 NG‐monomethyl‐L‐arginine (L‐NMMA) cream

1

34

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.11, 0.11]

10.16 Nicotinamide 1.4%, twice daily

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.17 Oleum horwathiensis

1

50

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.07, 0.07]

10.18 Omega‐3‐polyunsaturated fatty acids ointment

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.19 Platelet aggregation activating factor (PAF)(Ro 24‐0238)

1

104

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.04, 0.04]

10.20 Polymyxin B cream 200,000 U/g

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.21 PTH (1‐34) in Novasome A® liposomal cream, twice daily

1

30

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.12, 0.12]

10.22 Sirolimus (topical)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.23 Tacrolimus ointment

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.24 Tar

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.25 Tazarotene

2

414

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.01, 0.01]

10.26 Theophylline 1% ointment, twice daily

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 6. Other treatment versus placebo
Comparison 7. Vitamin D analogues versus corticosteroid (potent)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 IAGI Show forest plot

8

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 Calcipotriol vs. betamethasone dipropionate

3

1728

Std. Mean Difference (IV, Random, 95% CI)

0.43 [0.28, 0.58]

1.2 Calcipotriol vs. betamethasone valerate

1

412

Std. Mean Difference (IV, Random, 95% CI)

‐0.02 [‐0.21, 0.17]

1.3 Calcipotriol vs. desoxymetasone

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.4 Calcipotriol vs. diflorasone diacetate

1

256

Std. Mean Difference (IV, Random, 95% CI)

0.27 [0.02, 0.52]

1.5 Calcipotriol vs. fluocinonide

1

99

Std. Mean Difference (IV, Random, 95% CI)

‐0.58 [‐0.99, ‐0.18]

1.6 Calcitriol vs. betamethasone dipropionate

1

258

Std. Mean Difference (IV, Random, 95% CI)

0.21 [‐0.04, 0.45]

1.7 Calcitriol vs. betamethasone valerate

1

30

Std. Mean Difference (IV, Random, 95% CI)

‐0.19 [‐0.91, 0.53]

1.8 Tacalcitol vs. betamethasone valerate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2 TSS Show forest plot

6

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

2.1 Calcipotriol vs. betamethasone dipropionate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 Calcipotriol vs. betamethasone valerate

1

684

Std. Mean Difference (IV, Random, 95% CI)

‐0.26 [‐0.41, ‐0.11]

2.3 Calcipotriol vs. desoxymetasone

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.4 Calcipotriol vs. diflorasone diacetate

1

256

Std. Mean Difference (IV, Random, 95% CI)

0.40 [0.15, 0.65]

2.5 Calcipotriol vs. fluocinonide

1

89

Std. Mean Difference (IV, Random, 95% CI)

‐0.50 [‐0.92, ‐0.07]

2.6 Calcitriol vs. betamethasone dipropionate

1

258

Std. Mean Difference (IV, Random, 95% CI)

0.27 [0.02, 0.51]

2.7 Calcitriol vs. betamethasone valerate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.8 Tacalcitol vs. betamethasone valerate

2

148

Std. Mean Difference (IV, Random, 95% CI)

0.41 [0.09, 0.74]

3 PASI Show forest plot

9

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

3.1 Calcipotriol vs. betamethasone dipropionate

3

1728

Std. Mean Difference (IV, Random, 95% CI)

0.36 [0.22, 0.51]

3.2 Calcipotriol vs. betamethasone valerate

4

1505

Std. Mean Difference (IV, Random, 95% CI)

‐0.12 [‐0.22, ‐0.02]

3.3 Calcipotriol vs. desoxymetasone

1

20

Std. Mean Difference (IV, Random, 95% CI)

0.15 [‐0.73, 1.02]

3.4 Calcipotriol vs. diflorasone diacetate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.5 Calcipotriol vs. fluocinonide

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.6 Calcitriol vs. betamethasone dipropionate

1

258

Std. Mean Difference (IV, Random, 95% CI)

0.39 [0.14, 0.63]

3.7 Calcitriol vs. betamethasone valerate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.8 Tacalcitol vs. betamethasone valerate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4 PAGI Show forest plot

2

1080

Std. Mean Difference (IV, Random, 95% CI)

‐0.26 [‐0.38, ‐0.14]

4.1 Calcipotriol vs. betamethasone dipropionate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.2 Calcipotriol vs. betamethasone valerate

2

1080

Std. Mean Difference (IV, Random, 95% CI)

‐0.26 [‐0.38, ‐0.14]

4.3 Calcipotriol vs. desoxymetasone

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.4 Calcipotriol vs. diflorasone diacetate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.5 Calcipotriol vs. fluocinonide

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.6 Calcitriol vs. betamethasone dipropionate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.7 Calcitriol vs. betamethasone valerate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.8 Tacalcitol vs. betamethasone valerate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5 Combined end point (IAGI/TSS/PASI/PAGI) Show forest plot

14

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

5.1 Calcipotriol vs. betamethasone dipropionate

3

1728

Std. Mean Difference (IV, Random, 95% CI)

0.43 [0.28, 0.58]

5.2 Calcipotriol vs. betamethasone valerate

4

1557

Std. Mean Difference (IV, Random, 95% CI)

‐0.12 [‐0.26, 0.02]

5.3 Calcipotriol vs. desoxymetasone

1

20

Std. Mean Difference (IV, Random, 95% CI)

0.15 [‐0.73, 1.02]

5.4 Calcipotriol vs. diflorasone diacetate

1

256

Std. Mean Difference (IV, Random, 95% CI)

0.27 [0.02, 0.52]

5.5 Calcipotriol vs. fluocinonide

1

99

Std. Mean Difference (IV, Random, 95% CI)

‐0.58 [‐0.99, ‐0.18]

5.6 Calcitriol vs. betamethasone dipropionate

1

258

Std. Mean Difference (IV, Random, 95% CI)

0.21 [‐0.04, 0.45]

5.7 Calcitriol vs. betamethasone valerate

1

30

Std. Mean Difference (IV, Random, 95% CI)

‐0.19 [‐0.91, 0.53]

5.8 Tacalcitol vs. betamethasone valerate

2

148

Std. Mean Difference (IV, Random, 95% CI)

0.41 [0.09, 0.74]

6 Total withdrawals Show forest plot

11

3995

Risk Difference (M‐H, Random, 95% CI)

0.02 [0.00, 0.03]

6.1 Calcipotriol vs. betamethasone dipropionate

3

1739

Risk Difference (M‐H, Random, 95% CI)

0.03 [0.01, 0.06]

6.2 Calcipotriol vs. betamethasone valerate

3

1520

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.01, 0.04]

6.3 Calcipotriol vs. desoxymetasone

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.4 Calcipotriol vs. diflorasone diacetate

1

268

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.05, 0.05]

6.5 Calcipotriol vs. fluocinonide

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.6 Calcitriol vs. betamethasone dipropionate

1

258

Risk Difference (M‐H, Random, 95% CI)

‐0.02 [‐0.08, 0.03]

6.7 Calcitriol vs. betamethasone valerate

1

30

Risk Difference (M‐H, Random, 95% CI)

0.07 [‐0.10, 0.23]

6.8 Tacalcitol vs. betamethasone valerate

2

180

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.11, 0.11]

7 Withdrawals due to adverse events Show forest plot

9

3058

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.00, 0.01]

7.1 Calcipotriol vs. betamethasone dipropionate

1

956

Risk Difference (M‐H, Random, 95% CI)

0.02 [0.00, 0.04]

7.2 Calcipotriol vs. betamethasone valerate

3

1520

Risk Difference (M‐H, Random, 95% CI)

0.00 [‐0.00, 0.01]

7.3 Calcipotriol vs. desoxymetasone

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.4 Calcipotriol vs. diflorasone diacetate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.5 Calcipotriol vs. fluocinonide

1

114

Risk Difference (M‐H, Random, 95% CI)

‐0.02 [‐0.06, 0.03]

7.6 Calcitriol vs. betamethasone dipropionate

1

258

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.02, 0.03]

7.7 Calcitriol vs. betamethasone valerate

1

30

Risk Difference (M‐H, Random, 95% CI)

0.07 [‐0.10, 0.23]

7.8 Tacalcitol vs. betamethasone valerate

2

180

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.02, 0.02]

8 Withdrawals due to treatment failure Show forest plot

5

1500

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.01, 0.01]

8.1 Calcipotriol vs. betamethasone dipropionate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.2 Calcipotriol vs. betamethasone valerate

2

1099

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.01, 0.01]

8.3 Calcipotriol vs. desoxymetasone

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.4 Calcipotriol vs. diflorasone diacetate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.5 Calcipotriol vs. fluocinonide

1

113

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.03, 0.03]

8.6 Calcitriol vs. betamethasone dipropionate

1

258

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.03, 0.05]

8.7 Calcitriol vs. betamethasone valerate

1

30

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.12, 0.12]

8.8 Tacalcitol vs. betamethasone valerate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9 Adverse events (local) Show forest plot

9

3778

Risk Difference (M‐H, Random, 95% CI)

0.07 [0.02, 0.11]

9.1 Calcipotriol vs. betamethasone dipropionate

3

1739

Risk Difference (M‐H, Random, 95% CI)

0.07 [0.04, 0.09]

9.2 Calcipotriol vs. betamethasone valerate

3

1516

Risk Difference (M‐H, Random, 95% CI)

0.12 [‐0.02, 0.26]

9.3 Calcipotriol vs. desoxymetasone

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.4 Calcipotriol vs. diflorasone diacetate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.5 Calcipotriol vs. fluocinonide

1

113

Risk Difference (M‐H, Random, 95% CI)

0.10 [‐0.02, 0.22]

9.6 Calcitriol vs. betamethasone dipropionate

1

258

Risk Difference (M‐H, Random, 95% CI)

0.00 [‐0.05, 0.06]

9.7 Calcitriol vs. betamethasone valerate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.8 Tacalcitol vs. betamethasone valerate

1

152

Risk Difference (M‐H, Random, 95% CI)

‐0.01 [‐0.07, 0.04]

10 Adverse events (systemic) Show forest plot

6

2547

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.00, 0.00]

10.1 Calcipotriol vs. betamethasone dipropionate

1

621

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.01, 0.01]

10.2 Calcipotriol vs. betamethasone valerate

3

1516

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.00, 0.00]

10.3 Calcipotriol vs. desoxymetasone

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.4 Calcipotriol vs. diflorasone diacetate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.5 Calcipotriol vs. fluocinonide

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.6 Calcitriol vs. betamethasone dipropionate

1

258

Risk Difference (M‐H, Random, 95% CI)

‐0.01 [‐0.04, 0.03]

10.7 Calcitriol vs. betamethasone valerate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.8 Tacalcitol vs. betamethasone valerate

1

152

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.09, 0.09]

Figures and Tables -
Comparison 7. Vitamin D analogues versus corticosteroid (potent)
Comparison 8. Vitamin D analogues versus corticosteroid (very potent)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 IAGI Show forest plot

1

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

1.1 Calcipotriol vs. Clobetasol propionate

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2 TSS

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.1 Calcipotriol vs. Clobetasol propionate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3 PASI Show forest plot

1

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

3.1 Calcipotriol vs. Clobetasol propionate

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4 PAGI Show forest plot

1

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

4.1 Calcipotriol vs. Clobetasol propionate

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5 Combined end point (IAGI/TSS/PASI/PAGI) Show forest plot

2

82

Std. Mean Difference (IV, Random, 95% CI)

‐0.06 [‐0.57, 0.44]

5.1 Calcipotriol vs. Clobetasol propionate

2

82

Std. Mean Difference (IV, Random, 95% CI)

‐0.06 [‐0.57, 0.44]

6 Total withdrawals Show forest plot

1

Risk Difference (M‐H, Random, 95% CI)

Totals not selected

6.1 Calcipotriol vs. Clobetasol propionate

1

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7 Withdrawals due to adverse events Show forest plot

1

Risk Difference (M‐H, Random, 95% CI)

Totals not selected

7.1 Calcipotriol vs. Clobetasol propionate

1

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8 Withdrawals due to treatment failure Show forest plot

1

Risk Difference (M‐H, Random, 95% CI)

Totals not selected

8.1 Calcipotriol vs. Clobetasol propionate

1

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9 Adverse events (local) Show forest plot

1

Risk Difference (M‐H, Random, 95% CI)

Totals not selected

9.1 Calcipotriol vs. Clobetasol propionate

1

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10 Adverse events (systemic) Show forest plot

1

Risk Difference (M‐H, Random, 95% CI)

Totals not selected

10.1 Calcipotriol vs. Clobetasol propionate

1

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 8. Vitamin D analogues versus corticosteroid (very potent)
Comparison 9. Vitamin D combined with corticosteroid versus corticosteroid

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 IAGI Show forest plot

4

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 Calcipotriol + betamethasone dipropionate vs. betamethasone dipropionate

3

1926

Std. Mean Difference (IV, Random, 95% CI)

‐0.40 [‐0.52, ‐0.27]

1.2 Calcipotriol + betamethasone dipropionate vs. clobetasol propionate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 Calcipotriol + clobetasol propionate vs. clobetasol propionate

1

65

Std. Mean Difference (IV, Random, 95% CI)

‐0.69 [‐1.22, ‐0.15]

2 TSS Show forest plot

1

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

2.1 Calcipotriol + betamethasone dipropionate vs. betamethasone dipropionate

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 Calcipotriol + betamethasone dipropionate vs. clobetasol propionate

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.3 Calcipotriol + clobetasol propionate vs. clobetasol propionate

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3 PASI Show forest plot

3

1876

Std. Mean Difference (IV, Random, 95% CI)

‐0.44 [‐0.55, ‐0.33]

3.1 Calcipotriol + betamethasone dipropionate vs. betamethasone dipropionate

3

1876

Std. Mean Difference (IV, Random, 95% CI)

‐0.44 [‐0.55, ‐0.33]

3.2 Calcipotriol + betamethasone dipropionate vs. clobetasol propionate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.3 Calcipotriol + clobetasol propionate vs. clobetasol propionate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4 PAGI Show forest plot

1

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

4.1 Calcipotriol + betamethasone dipropionate vs. betamethasone dipropionate

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.2 Calcipotriol + betamethasone dipropionate vs. clobetasol propionate

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.3 Calcipotriol + clobetasol propionate vs. clobetasol propionate

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5 Combined end point (IAGI/TSS/PASI/PAGI) Show forest plot

5

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

5.1 Calcipotriol + betamethasone dipropionate vs. betamethasone dipropionate

3

1926

Std. Mean Difference (IV, Random, 95% CI)

‐0.40 [‐0.52, ‐0.27]

5.2 Calcipotriol + betamethasone dipropionate vs. clobetasol propionate

1

122

Std. Mean Difference (IV, Random, 95% CI)

0.45 [0.09, 0.81]

5.3 Calcipotriol + clobetasol propionate vs. clobetasol propionate

1

65

Std. Mean Difference (IV, Random, 95% CI)

‐0.69 [‐1.22, ‐0.15]

6 Total withdrawals Show forest plot

5

2135

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.02, 0.01]

6.1 Calcipotriol + betamethasone dipropionate vs. betamethasone dipropionate

3

1948

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.03, 0.03]

6.2 Calcipotriol + betamethasone dipropionate vs. clobetasol propionate

1

122

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.03, 0.03]

6.3 Calcipotriol + clobetasol propionate vs. clobetasol propionate

1

65

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.07, 0.07]

7 Withdrawals due to adverse events Show forest plot

3

Risk Difference (M‐H, Random, 95% CI)

Totals not selected

7.1 Calcipotriol + betamethasone dipropionate vs. betamethasone dipropionate

1

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.2 Calcipotriol + betamethasone dipropionate vs. clobetasol propionate

1

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.3 Calcipotriol + clobetasol propionate vs. clobetasol propionate

1

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8 Withdrawals due to treatment failure Show forest plot

2

Risk Difference (M‐H, Random, 95% CI)

Totals not selected

8.1 Calcipotriol + betamethasone dipropionate vs. betamethasone dipropionate

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.2 Calcipotriol + betamethasone dipropionate vs. clobetasol propionate

1

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.3 Calcipotriol + clobetasol propionate vs. clobetasol propionate

1

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9 Adverse events (local) Show forest plot

4

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

9.1 Calcipotriol + betamethasone dipropionate vs. betamethasone dipropionate

3

1946

Risk Difference (M‐H, Random, 95% CI)

0.02 [‐0.00, 0.04]

9.2 Calcipotriol + betamethasone dipropionate vs. clobetasol propionate

1

122

Risk Difference (M‐H, Random, 95% CI)

‐0.04 [‐0.13, 0.06]

9.3 Calcipotriol + clobetasol propionate vs. clobetasol propionate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10 Adverse events (systemic) Show forest plot

1

Risk Difference (M‐H, Random, 95% CI)

Totals not selected

10.1 Calcipotriol + betamethasone dipropionate vs. betamethasone dipropionate

1

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.2 Calcipotriol + betamethasone dipropionate vs. clobetasol propionate

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.3 Calcipotriol + clobetasol propionate vs. clobetasol propionate

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 9. Vitamin D combined with corticosteroid versus corticosteroid
Comparison 10. Vitamin D alone or in combination versus dithranol

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 IAGI Show forest plot

5

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 Calcipotriol vs. dithranol

4

994

Std. Mean Difference (IV, Random, 95% CI)

‐0.43 [‐0.85, ‐0.01]

1.2 Calcitriol vs. dithranol

1

114

Std. Mean Difference (IV, Random, 95% CI)

0.51 [0.13, 0.88]

1.3 Tacalcitol vs. dithranol

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2 TSS Show forest plot

4

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

2.1 Calcipotriol vs. dithranol

2

210

Std. Mean Difference (IV, Random, 95% CI)

‐0.54 [‐1.16, 0.08]

2.2 Calcitriol vs. dithranol

1

114

Std. Mean Difference (IV, Random, 95% CI)

0.13 [‐0.24, 0.50]

2.3 Tacalcitol vs. dithranol

1

84

Std. Mean Difference (IV, Random, 95% CI)

‐0.18 [‐0.60, 0.25]

3 PASI Show forest plot

5

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

3.1 Calcipotriol vs. dithranol

3

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.2 Calcitriol vs. dithranol

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.3 Tacalcitol vs. dithranol

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4 PAGI Show forest plot

2

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

4.1 Calcipotriol vs. dithranol

2

544

Std. Mean Difference (IV, Random, 95% CI)

‐0.05 [‐0.90, 0.80]

4.2 Calcitriol vs. dithranol

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.3 Tacalcitol vs. dithranol

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5 Combined end point (IAGI/TSS/PASI/PAGI) Show forest plot

8

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

5.1 Calcipotriol vs. dithranol

6

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5.2 Calcitriol vs. dithranol

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5.3 Tacalcitol vs. dithranol

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

6 Total withdrawals Show forest plot

7

615

Risk Difference (M‐H, Random, 95% CI)

‐0.02 [‐0.06, 0.01]

6.1 Calcipotriol vs. dithranol

5

417

Risk Difference (M‐H, Random, 95% CI)

‐0.01 [‐0.07, 0.04]

6.2 Calcitriol vs. dithranol

1

114

Risk Difference (M‐H, Random, 95% CI)

‐0.10 [‐0.25, 0.06]

6.3 Tacalcitol vs. dithranol

1

84

Risk Difference (M‐H, Random, 95% CI)

‐0.02 [‐0.16, 0.11]

7 Withdrawals due to adverse events Show forest plot

7

1265

Risk Difference (M‐H, Random, 95% CI)

‐0.03 [‐0.06, ‐0.00]

7.1 Calcipotriol vs. dithranol

6

1151

Risk Difference (M‐H, Random, 95% CI)

‐0.03 [‐0.06, 0.00]

7.2 Calcitriol vs. dithranol

1

114

Risk Difference (M‐H, Random, 95% CI)

‐0.06 [‐0.13, 0.02]

7.3 Tacalcitol vs. dithranol

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8 Withdrawals due to treatment failure Show forest plot

5

788

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.02, 0.02]

8.1 Calcipotriol vs. dithranol

4

674

Risk Difference (M‐H, Random, 95% CI)

0.00 [‐0.02, 0.02]

8.2 Calcitriol vs. dithranol

1

114

Risk Difference (M‐H, Random, 95% CI)

‐0.02 [‐0.08, 0.04]

8.3 Tacalcitol vs. dithranol

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9 Adverse events (local) Show forest plot

9

1543

Risk Difference (M‐H, Random, 95% CI)

‐0.32 [‐0.43, ‐0.20]

9.1 Calcipotriol vs. dithranol

7

1345

Risk Difference (M‐H, Random, 95% CI)

‐0.25 [‐0.32, ‐0.17]

9.2 Calcitriol vs. dithranol

1

114

Risk Difference (M‐H, Random, 95% CI)

‐0.67 [‐0.80, ‐0.54]

9.3 Tacalcitol vs. dithranol

1

84

Risk Difference (M‐H, Random, 95% CI)

‐0.36 [‐0.52, ‐0.20]

10 Adverse events (systemic) Show forest plot

4

746

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.01, 0.01]

10.1 Calcipotriol vs. dithranol

2

548

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.02, 0.01]

10.2 Calcitriol vs. dithranol

1

114

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.03, 0.03]

10.3 Tacalcitol vs. dithranol

1

84

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.05, 0.05]

Figures and Tables -
Comparison 10. Vitamin D alone or in combination versus dithranol
Comparison 11. Vitamin D alone or in combination versus other vitamin D analogue

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 IAGI Show forest plot

3

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 Calcipotriol vs. calcitriol

1

246

Std. Mean Difference (IV, Random, 95% CI)

0.0 [‐0.25, 0.25]

1.2 Calcipotriol vs. tacalcitol

1

226

Std. Mean Difference (IV, Random, 95% CI)

‐0.47 [‐0.73, ‐0.21]

1.3 Calcipotriol vs. maxacalcitol

1

52

Std. Mean Difference (IV, Random, 95% CI)

0.43 [‐0.12, 0.98]

2 TSS Show forest plot

3

589

Std. Mean Difference (IV, Random, 95% CI)

‐0.31 [‐0.55, ‐0.06]

2.1 Calcipotriol vs. calcitriol

1

250

Std. Mean Difference (IV, Random, 95% CI)

‐0.32 [‐0.57, ‐0.07]

2.2 Calcipotriol vs. tacalcitol

1

287

Std. Mean Difference (IV, Random, 95% CI)

‐0.45 [‐0.68, ‐0.22]

2.3 Calcipotriol vs. maxacalcitol

1

52

Std. Mean Difference (IV, Random, 95% CI)

0.13 [‐0.41, 0.68]

3 PASI Show forest plot

1

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

3.1 Calcipotriol vs. calcitriol

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.2 Calcipotriol vs. tacalcitol

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.3 Calcipotriol vs. maxacalcitol

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4 PAGI Show forest plot

1

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

4.1 Calcipotriol vs. calcitriol

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.2 Calcipotriol vs. tacalcitol

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.3 Calcipotriol vs. maxacalcitol

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5 Combined end point (IAGI/TSS/PASI/PAGI) Show forest plot

4

539

Std. Mean Difference (IV, Random, 95% CI)

‐0.17 [‐0.62, 0.27]

5.1 Calcipotriol vs. calcitriol

2

261

Std. Mean Difference (IV, Random, 95% CI)

‐0.41 [‐1.46, 0.64]

5.2 Calcipotriol vs. tacalcitol

1

226

Std. Mean Difference (IV, Random, 95% CI)

‐0.47 [‐0.73, ‐0.21]

5.3 Calcipotriol vs. maxacalcitol

1

52

Std. Mean Difference (IV, Random, 95% CI)

0.43 [‐0.12, 0.98]

6 Total withdrawals Show forest plot

3

334

Risk Difference (M‐H, Random, 95% CI)

0.02 [‐0.04, 0.08]

6.1 Calcipotriol vs. calcitriol

2

274

Risk Difference (M‐H, Random, 95% CI)

0.02 [‐0.04, 0.09]

6.2 Calcipotriol vs. tacalcitol

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.3 Calcipotriol vs. maxacalcitol

1

60

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.17, 0.17]

7 Withdrawals due to adverse events Show forest plot

3

334

Risk Difference (M‐H, Random, 95% CI)

0.02 [‐0.01, 0.06]

7.1 Calcipotriol vs. calcitriol

2

274

Risk Difference (M‐H, Random, 95% CI)

0.03 [‐0.01, 0.07]

7.2 Calcipotriol vs. tacalcitol

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.3 Calcipotriol vs. maxacalcitol

1

60

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.06, 0.06]

8 Withdrawals due to treatment failure Show forest plot

3

334

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.02, 0.01]

8.1 Calcipotriol vs. calcitriol

2

274

Risk Difference (M‐H, Random, 95% CI)

‐0.01 [‐0.08, 0.07]

8.2 Calcipotriol vs. tacalcitol

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.3 Calcipotriol vs. maxacalcitol

1

60

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.06, 0.06]

9 Adverse events (local) Show forest plot

2

537

Risk Difference (M‐H, Random, 95% CI)

0.03 [‐0.05, 0.12]

9.1 Calcipotriol vs. calcitriol

1

250

Risk Difference (M‐H, Random, 95% CI)

0.07 [0.01, 0.14]

9.2 Calcipotriol vs. tacalcitol

1

287

Risk Difference (M‐H, Random, 95% CI)

‐0.01 [‐0.09, 0.07]

9.3 Calcipotriol vs. maxacalcitol

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10 Adverse events (systemic) Show forest plot

3

597

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.01, 0.01]

10.1 Calcipotriol vs. calcitriol

1

250

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.02, 0.02]

10.2 Calcipotriol vs. tacalcitol

1

287

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.01, 0.01]

10.3 Calcipotriol vs. maxacalcitol

1

60

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.06, 0.06]

Figures and Tables -
Comparison 11. Vitamin D alone or in combination versus other vitamin D analogue
Comparison 12. Vitamin D alone or in combination versus vitamin D + corticosteroid

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 IAGI Show forest plot

11

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 Calcipotriol twice daily vs. calcipotriol OM, BMD ON

1

154

Std. Mean Difference (IV, Random, 95% CI)

0.56 [0.23, 0.88]

1.2 Calcipotriol OD vs. combined calcipotriol + BMD OD

2

1194

Std. Mean Difference (IV, Random, 95% CI)

0.66 [0.31, 1.02]

1.3 Calcipotriol twice daily vs. combined calcipotriol + BMD OD

1

377

Std. Mean Difference (IV, Random, 95% CI)

0.27 [0.06, 0.48]

1.4 Calcipotriol twice daily vs. combined calcipotriol + BMD twice daily

3

1804

Std. Mean Difference (IV, Random, 95% CI)

0.66 [0.40, 0.93]

1.5 Calcipotriol twice daily vs. calcipotriol OM, BMV ON

2

510

Std. Mean Difference (IV, Random, 95% CI)

0.27 [‐0.19, 0.74]

1.6 Calcipotriol twice daily vs. calcipotriol OM, clobetasone butyrate ON

1

344

Std. Mean Difference (IV, Random, 95% CI)

0.27 [0.05, 0.48]

1.7 Calcipotriol twice daily vs. calcipotriol twice daily + clobetasol propionate twice daily

1

65

Std. Mean Difference (IV, Random, 95% CI)

0.88 [0.34, 1.42]

1.8 Calcipotriol twice daily vs. calcipotriol OM, diflucortolone valerate ON

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.9 Calcipotriol OD vs. calcipotriol OM, fluocinonide acetonide ON

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.10 Calcipotriol OD vs. combined calcipotriol + hydrocortisone OD

1

408

Std. Mean Difference (IV, Random, 95% CI)

0.14 [‐0.06, 0.33]

1.11 Calcitriol twice daily vs. diflucortolone valerate OM, calcitriol ON

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.12 Tacalcitol OD vs. combined calcipotriol + BMD OD

1

334

Std. Mean Difference (IV, Random, 95% CI)

0.48 [0.26, 0.70]

2 TSS Show forest plot

1

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

2.1 Calcipotriol twice daily vs. calcipotriol OM, BMD ON

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 Calcipotriol OD vs. combined calcipotriol + BMD OD

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.3 Calcipotriol twice daily vs. combined calcipotriol + BMD OD

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.4 Calcipotriol twice daily vs. combined calcipotriol + BMD twice daily

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.5 Calcipotriol twice daily vs. calcipotriol OM, BMV ON

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.6 Calcipotriol twice daily vs. calcipotriol OM, clobetasone butyrate ON

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.7 Calcipotriol twice daily vs. calcipotriol twice daily + clobetasol propionate twice daily

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.8 Calcipotriol twice daily vs. calcipotriol OM, diflucortolone valerate ON

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.9 Calcipotriol OD vs. calcipotriol OM, fluocinonide acetonide ON

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.10 Calcipotriol OD vs. combined calcipotriol + hydrocortisone OD

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.11 Calcitriol twice daily vs. diflucortolone valerate OM, calcitriol ON

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.12 Tacalcitol OD vs. combined calcipotriol + BMD OD

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3 PASI Show forest plot

16

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

3.1 Calcipotriol twice daily vs. calcipotriol OM, BMD ON

1

124

Std. Mean Difference (IV, Random, 95% CI)

0.46 [0.10, 0.82]

3.2 Calcipotriol OD vs. combined calcipotriol + BMD OD

2

1191

Std. Mean Difference (IV, Random, 95% CI)

0.67 [0.23, 1.11]

3.3 Calcipotriol twice daily vs. combined calcipotriol + BMD OD

4

1204

Std. Mean Difference (IV, Random, 95% CI)

0.52 [0.38, 0.67]

3.4 Calcipotriol twice daily vs. combined calcipotriol + BMD twice daily

3

1744

Std. Mean Difference (IV, Random, 95% CI)

0.64 [0.46, 0.83]

3.5 Calcipotriol twice daily vs. calcipotriol OM, BMV ON

2

515

Std. Mean Difference (IV, Random, 95% CI)

0.43 [‐0.07, 0.93]

3.6 Calcipotriol twice daily vs. calcipotriol OM, clobetasone butyrate ON

1

344

Std. Mean Difference (IV, Random, 95% CI)

0.17 [‐0.04, 0.38]

3.7 Calcipotriol twice daily vs. calcipotriol twice daily + clobetasol propionate twice daily

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.8 Calcipotriol twice daily vs. calcipotriol OM, diflucortolone valerate ON

1

116

Std. Mean Difference (IV, Random, 95% CI)

0.08 [‐0.29, 0.44]

3.9 Calcipotriol OD vs. calcipotriol OM, fluocinonide acetonide ON

1

38

Std. Mean Difference (IV, Random, 95% CI)

0.53 [‐0.11, 1.18]

3.10 Calcipotriol OD vs. combined calcipotriol + hydrocortisone OD

1

408

Std. Mean Difference (IV, Random, 95% CI)

0.08 [‐0.11, 0.28]

3.11 Calcitriol twice daily vs. diflucortolone valerate OM, calcitriol ON

1

142

Std. Mean Difference (IV, Random, 95% CI)

0.24 [‐0.09, 0.57]

3.12 Tacalcitol OD vs. combined calcipotriol + BMD OD

1

334

Std. Mean Difference (IV, Random, 95% CI)

0.47 [0.25, 0.69]

4 PAGI Show forest plot

2

399

Std. Mean Difference (IV, Random, 95% CI)

0.49 [0.29, 0.69]

4.1 Calcipotriol twice daily vs. calcipotriol OM, BMD ON

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.2 Calcipotriol OD vs. combined calcipotriol + BMD OD

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.3 Calcipotriol twice daily vs. combined calcipotriol + BMD OD

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.4 Calcipotriol twice daily vs. combined calcipotriol + BMD twice daily

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.5 Calcipotriol twice daily vs. calcipotriol OM, BMV ON

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.6 Calcipotriol twice daily vs. calcipotriol OM, clobetasone butyrate ON

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.7 Calcipotriol twice daily vs. calcipotriol twice daily + clobetasol propionate twice daily

1

65

Std. Mean Difference (IV, Random, 95% CI)

0.70 [0.16, 1.23]

4.8 Calcipotriol twice daily vs. calcipotriol OM, diflucortolone valerate ON

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.9 Calcipotriol OD vs. calcipotriol OM, fluocinonide acetonide ON

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.10 Calcipotriol OD vs. combined calcipotriol + hydrocortisone OD

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.11 Calcitriol twice daily vs. diflucortolone valerate OM, calcitriol ON

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.12 Tacalcitol OD vs. combined calcipotriol + BMD OD

1

334

Std. Mean Difference (IV, Random, 95% CI)

0.46 [0.24, 0.68]

5 Combined end point (IAGI/TSS/PASI/PAGI) Show forest plot

17

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

5.1 Calcipotriol twice daily vs. calcipotriol OM, BMD ON

1

154

Std. Mean Difference (IV, Random, 95% CI)

0.56 [0.23, 0.88]

5.2 Calcipotriol OD vs. combined calcipotriol + BMD OD

2

1194

Std. Mean Difference (IV, Random, 95% CI)

0.66 [0.31, 1.02]

5.3 Calcipotriol twice daily vs. combined calcipotriol + BMD OD

4

1204

Std. Mean Difference (IV, Random, 95% CI)

0.43 [0.20, 0.66]

5.4 Calcipotriol twice daily vs. combined calcipotriol + BMD twice daily

3

1804

Std. Mean Difference (IV, Random, 95% CI)

0.66 [0.40, 0.93]

5.5 Calcipotriol twice daily vs. calcipotriol OM, BMV ON

2

510

Std. Mean Difference (IV, Random, 95% CI)

0.27 [‐0.19, 0.74]

5.6 Calcipotriol twice daily vs. calcipotriol OM, clobetasone butyrate ON

1

344

Std. Mean Difference (IV, Random, 95% CI)

0.27 [0.05, 0.48]

5.7 Calcipotriol twice daily vs. calcipotriol twice daily + clobetasol propionate twice daily

1

65

Std. Mean Difference (IV, Random, 95% CI)

0.88 [0.34, 1.42]

5.8 Calcipotriol twice daily vs. calcipotriol OM, diflucortolone valerate ON

1

116

Std. Mean Difference (IV, Random, 95% CI)

0.08 [‐0.29, 0.44]

5.9 Calcipotriol OD vs. calcipotriol OM, fluocinonide acetonide ON

1

38

Std. Mean Difference (IV, Random, 95% CI)

0.53 [‐0.11, 1.18]

5.10 Calcipotriol OD vs. combined calcipotriol + hydrocortisone OD

1

408

Std. Mean Difference (IV, Random, 95% CI)

0.14 [‐0.06, 0.33]

5.11 Calcitriol twice daily vs. diflucortolone valerate OM, calcitriol ON

1

142

Std. Mean Difference (IV, Random, 95% CI)

0.24 [‐0.09, 0.57]

5.12 Tacalcitol OD vs. combined calcipotriol + BMD OD

1

334

Std. Mean Difference (IV, Random, 95% CI)

0.48 [0.26, 0.70]

6 Total withdrawals Show forest plot

15

5494

Risk Difference (M‐H, Random, 95% CI)

0.03 [0.02, 0.05]

6.1 Talcipotriol vs. calcipotriol and corticosteroid

13

4985

Risk Difference (M‐H, Random, 95% CI)

0.03 [0.01, 0.05]

6.2 Calcitriol vs. calcitriol and corticosteroid

1

142

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.08, 0.10]

6.3 Tacalcitol vs. calcipotriol and corticosteroid

1

367

Risk Difference (M‐H, Random, 95% CI)

0.05 [‐0.01, 0.11]

7 Withdrawals due to adverse events Show forest plot

13

4081

Risk Difference (M‐H, Random, 95% CI)

0.02 [0.01, 0.03]

7.1 Calcipotriol vs. calcipotriol and corticosteroid

11

3572

Risk Difference (M‐H, Random, 95% CI)

0.02 [0.01, 0.03]

7.2 Calcitriol vs. calcitriol and corticosteroid

1

142

Risk Difference (M‐H, Random, 95% CI)

0.03 [‐0.02, 0.07]

7.3 Tacalcitol vs. calcipotriol and corticosteroid

1

367

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.02, 0.03]

8 Withdrawals due to treatment failure Show forest plot

7

1925

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.00, 0.02]

8.1 Calcipotriol vs. calcipotriol and corticosteroid

7

1925

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.00, 0.02]

8.2 Calcitriol vs. calcitriol and corticosteroid

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.3 Tacalcitol vs. calcipotriol and corticosteroid

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9 Adverse events (local) Show forest plot

15

5581

Risk Difference (M‐H, Random, 95% CI)

0.06 [0.05, 0.08]

9.1 Calcipotriol vs. calcipotriol and corticosteroid

13

5084

Risk Difference (M‐H, Random, 95% CI)

0.06 [0.04, 0.08]

9.2 Calcitriol vs. calcitriol and corticosteroid

1

131

Risk Difference (M‐H, Random, 95% CI)

0.10 [0.02, 0.19]

9.3 Tacalcitol vs. calcipotriol and corticosteroid

1

366

Risk Difference (M‐H, Random, 95% CI)

0.09 [0.02, 0.15]

10 Adverse events (systemic) Show forest plot

6

2099

Risk Difference (M‐H, Random, 95% CI)

0.00 [‐0.00, 0.00]

10.1 Calcipotriol vs. calcipotriol and corticosteroid

5

1968

Risk Difference (M‐H, Random, 95% CI)

0.00 [‐0.00, 0.00]

10.2 Calcitriol vs. calcitriol and corticosteroid

1

131

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.03, 0.03]

10.3 Tacalcitol vs. calcipotriol and corticosteroid

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 12. Vitamin D alone or in combination versus vitamin D + corticosteroid
Comparison 13. Vitamin D alone or in combination versus other treatments: complex regimens

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 IAGI Show forest plot

7

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (8 wks); then calcipotriol (4 wks)

1

577

Std. Mean Difference (IV, Random, 95% CI)

‐0.12 [‐0.29, 0.04]

1.2 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (8 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) & combined calcipotriol + BMD (w/e) (8 wks)

1

585

Std. Mean Difference (IV, Random, 95% CI)

0.13 [‐0.04, 0.29]

1.4 Calcipotriol (6 wks) vs. clobetasol propionate (2 wks); then calcipotriol (4 wks)

1

92

Std. Mean Difference (IV, Random, 95% CI)

0.60 [0.18, 1.02]

1.5 Calcipotriol (6 wks) vs. calcipotriol OM, fluocinonide acetonide ON (2 wks); then calcipotriol twice daily (4 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.6 Calcipotriol (6 wks) vs. halometasone OM, calcipotriol ON (2 wks); then calcipotriol twice daily (w/dy), halometasone (w/e) (2 wks); then calcipotriol twice daily (2wks)

1

76

Std. Mean Difference (IV, Random, 95% CI)

0.41 [‐0.05, 0.86]

1.7 Calcipotriol ON, clobetasol propionate OM (2 to 4 wks); then calcipotriol twice daily (to wk 12) vs. calcitriol ON, clobetasol propionate OM (2 to 4 wks); then calcitriol twice daily (to wk 12)

1

125

Std. Mean Difference (IV, Random, 95% CI)

‐0.19 [‐0.54, 0.16]

1.8 Combined calcipotriol + BMD (4 wks); then placebo ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol ointment twice daily (8 wks)

1

759

Std. Mean Difference (IV, Random, 95% CI)

0.27 [0.12, 0.41]

1.9 Combined calcipotriol + BMD (4 wks); then placebo ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy)+ combined calcipotriol + BMD (w/e) (8 wks)

1

753

Std. Mean Difference (IV, Random, 95% CI)

0.51 [0.37, 0.66]

1.10 Combined calcipotriol + BMD (4 wks); then calcipotriol ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy)+ combined calcipotriol + BMD (w/e) (8 wks)

1

760

Std. Mean Difference (IV, Random, 95% CI)

0.26 [0.11, 0.40]

1.11 Combined calcipotriol + BMD (8 wks); then calcipotriol (4 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) & combined calcipotriol + BMD (w/e) (8 wks)

1

596

Std. Mean Difference (IV, Random, 95% CI)

0.24 [0.08, 0.40]

1.12 Tacalcitol (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks)

1

493

Std. Mean Difference (IV, Random, 95% CI)

0.54 [0.36, 0.72]

2 TSS Show forest plot

1

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

2.1 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (8 wks); then calcipotriol (4 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (8 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.3 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) & combined calcipotriol + BMD (w/e) (8 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.4 Calcipotriol (6 wks) vs. clobetasol propionate (2wks); then calcipotriol (4 wks)

1

92

Std. Mean Difference (IV, Random, 95% CI)

0.63 [0.21, 1.05]

2.5 Calcipotriol (6 wks) vs. calcipotriol OM, fluocinonide acetonide ON (2 wks); then calcipotriol twice daily (4 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.6 Calcipotriol (6 wks) vs. halometasone OM, calcipotriol ON (2 wks); then calcipotriol twice daily (w/dy), halometasone (w/e) (2 wks); then calcipotriol twice daily (2 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.7 Calcipotriol ON, clobetasol propionate OM (2 to 4 wks); then calcipotriol twice daily (to wk 12) vs. calcitriol ON, clobetasol propionate OM (2 to 4 wks); then calcitriol twice daily (to wk 12)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.8 Combined calcipotriol + BMD (4 wks); then placebo ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol ointment twice daily (8 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.9 Combined calcipotriol + BMD (4 wks); then placebo ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) + combined calcipotriol + BMD (w/e) (8 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.10 Combined calcipotriol + BMD (4 wks); then calcipotriol ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) + combined calcipotriol + BMD (w/e) (8 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.11 Combined calcipotriol + BMD (8 wks); then calcipotriol (4 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) & combined calcipotriol + BMD (w/e) (8 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.12 Tacalcitol (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3 PASI Show forest plot

8

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

3.1 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (8 wks); then calcipotriol (4 wks)

1

649

Std. Mean Difference (IV, Random, 95% CI)

‐0.04 [‐0.19, 0.11]

3.2 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (8 wks)

1

143

Std. Mean Difference (IV, Random, 95% CI)

0.29 [‐0.04, 0.62]

3.3 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) & combined calcipotriol + BMD (w/e) (8 wks)

1

650

Std. Mean Difference (IV, Random, 95% CI)

0.10 [‐0.05, 0.25]

3.4 Calcipotriol (6 wks) vs. clobetasol propionate (2 wks); then calcipotriol (4 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.5 Calcipotriol (6 wks) vs. calcipotriol OM, fluocinonide acetonide ON (2 wks); then calcipotriol twice daily (4 wks)

1

38

Std. Mean Difference (IV, Random, 95% CI)

0.66 [0.01, 1.32]

3.6 Calcipotriol (6 wks) vs. halometasone OM, calcipotriol ON (2 wks); then calcipotriol twice daily (w/dy), halometasone (w/e) (2 wks); then calcipotriol twice daily (2 wks)

1

76

Std. Mean Difference (IV, Random, 95% CI)

1.13 [0.64, 1.62]

3.7 Calcipotriol ON, clobetasol propionate OM (2 to 4 wks); then calcipotriol twice daily (to wk 12) vs. calcitriol ON, clobetasol propionate OM (2 to 4 wks); then calcitriol twice daily (to wk 12)

1

125

Std. Mean Difference (IV, Random, 95% CI)

‐0.27 [‐0.62, 0.09]

3.8 Combined calcipotriol + BMD (4 wks); then placebo ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol ointment twice daily (8 wks)

1

759

Std. Mean Difference (IV, Random, 95% CI)

0.25 [0.10, 0.39]

3.9 Combined calcipotriol + BMD (4 wks); then placebo ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) + combined calcipotriol + BMD (w/e) (8 wks)

1

753

Std. Mean Difference (IV, Random, 95% CI)

0.59 [0.45, 0.74]

3.10 Combined calcipotriol + BMD (4 wks); then calcipotriol ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) + combined calcipotriol + BMD (w/e) (8 wks)

1

760

Std. Mean Difference (IV, Random, 95% CI)

0.30 [0.16, 0.45]

3.11 Combined calcipotriol + BMD (8 wks); then calcipotriol (4 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) & combined calcipotriol + BMD (w/e) (8 wks)

1

645

Std. Mean Difference (IV, Random, 95% CI)

0.15 [‐0.01, 0.30]

3.12 Tacalcitol (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks)

1

501

Std. Mean Difference (IV, Random, 95% CI)

0.49 [0.31, 0.67]

4 PAGI Show forest plot

4

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

4.1 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (8 wks); then calcipotriol (4 wks)

1

577

Std. Mean Difference (IV, Random, 95% CI)

‐0.14 [‐0.30, 0.02]

4.2 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (8 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.3 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) & combined calcipotriol + BMD (w/e) (8 wks)

1

585

Std. Mean Difference (IV, Random, 95% CI)

0.10 [‐0.06, 0.26]

4.4 Calcipotriol (6 wks) vs. clobetasol propionate (2 wks); then calcipotriol (4 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.5 Calcipotriol (6 wks) vs. calcipotriol OM, fluocinonide acetonide ON (2 wks); then calcipotriol twice daily (4 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.6 Calcipotriol (6 wks) vs. halometasone OM, calcipotriol ON (2 wks); then calcipotriol twice daily (w/dy), halometasone (w/e) (2 wks); then calcipotriol twice daily (2 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.7 Calcipotriol ON, clobetasol propionate OM (2 to 4 wks); then calcipotriol twice daily (to wk 12) vs. calcitriol ON, clobetasol propionate OM (2 to 4 wks); then calcitriol twice daily (to wk 12)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.8 Combined calcipotriol + BMD (4 wks); then placebo ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol ointment twice daily (8 wks)

1

759

Std. Mean Difference (IV, Random, 95% CI)

0.28 [0.13, 0.42]

4.9 Combined calcipotriol + BMD (4 wks); then placebo ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) + combined calcipotriol + BMD (w/e) (8 wks)

1

753

Std. Mean Difference (IV, Random, 95% CI)

0.71 [0.56, 0.85]

4.10 Combined calcipotriol + BMD (4 wks); then calcipotriol ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) + combined calcipotriol + BMD (w/e) (8 wks)

1

760

Std. Mean Difference (IV, Random, 95% CI)

0.44 [0.29, 0.58]

4.11 Combined calcipotriol + BMD (8 wks); then calcipotriol (4 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) & combined calcipotriol + BMD (w/e) (8 wks)

1

596

Std. Mean Difference (IV, Random, 95% CI)

0.23 [0.07, 0.39]

4.12 Tacalcitol (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks)

1

493

Std. Mean Difference (IV, Random, 95% CI)

0.54 [0.36, 0.72]

5 Combined end point (IAGI/TSS/PASI/PAGI) Show forest plot

9

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

5.1 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (8 wks); then calcipotriol (4 wks)

1

577

Std. Mean Difference (IV, Random, 95% CI)

‐0.12 [‐0.29, 0.04]

5.2 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (8 wks)

1

143

Std. Mean Difference (IV, Random, 95% CI)

0.29 [‐0.04, 0.62]

5.3 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) & combined calcipotriol + BMD (w/e) (8 wks)

1

585

Std. Mean Difference (IV, Random, 95% CI)

0.13 [‐0.04, 0.29]

5.4 Calcipotriol (6 wks) vs. clobetasol propionate (2 wks); then calcipotriol (4 wks)

1

92

Std. Mean Difference (IV, Random, 95% CI)

0.60 [0.18, 1.02]

5.5 Calcipotriol (6 wks) vs. calcipotriol OM, fluocinonide acetonide ON (2 wks); then calcipotriol twice daily (4 wks)

1

38

Std. Mean Difference (IV, Random, 95% CI)

0.66 [0.01, 1.32]

5.6 Calcipotriol (6 wks) vs. halometasone OM, calcipotriol ON (2 wks); then calcipotriol twice daily (w/dy), halometasone (w/e) (2 wks); then calcipotriol twice daily (2 wks)

1

76

Std. Mean Difference (IV, Random, 95% CI)

0.41 [‐0.05, 0.86]

5.7 Calcipotriol ON, clobetasol propionate OM (2 to 4 wks); then calcipotriol twice daily (to wk 12) vs. calcitriol ON, clobetasol propionate OM (2 to 4 wks); then calcitriol twice daily (to wk 12)

1

125

Std. Mean Difference (IV, Random, 95% CI)

‐0.19 [‐0.54, 0.16]

5.8 Combined calcipotriol + BMD (4 wks); then placebo ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol ointment twice daily (8 wks)

1

759

Std. Mean Difference (IV, Random, 95% CI)

0.27 [0.12, 0.41]

5.9 Combined calcipotriol + BMD (4 wks); then placebo ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy)+ combined calcipotriol + BMD (w/e) (8 wks)

1

753

Std. Mean Difference (IV, Random, 95% CI)

0.51 [0.37, 0.66]

5.10 Combined calcipotriol + BMD (4 wks); then calcipotriol ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) + combined calcipotriol + BMD (w/e) (8 wks)

1

760

Std. Mean Difference (IV, Random, 95% CI)

0.26 [0.11, 0.40]

5.11 Combined calcipotriol + BMD (8 wks); then calcipotriol (4 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) & combined calcipotriol + BMD (w/e) (8 wks)

1

596

Std. Mean Difference (IV, Random, 95% CI)

0.24 [0.08, 0.40]

5.12 Tacalcitol (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks)

1

493

Std. Mean Difference (IV, Random, 95% CI)

0.54 [0.36, 0.72]

6 Total withdrawals Show forest plot

9

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

6.1 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (8 wks); then calcipotriol (4 wks)

1

649

Risk Difference (M‐H, Random, 95% CI)

0.05 [0.00, 0.10]

6.2 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (8 wks)

1

150

Risk Difference (M‐H, Random, 95% CI)

0.04 [‐0.09, 0.17]

6.3 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) & combined calcipotriol + BMD (w/e) (8 wks)

1

649

Risk Difference (M‐H, Random, 95% CI)

0.08 [0.03, 0.13]

6.4 Calcipotriol (6 wks) vs. clobetasol propionate (2 wks); then calcipotriol (4 wks)

1

98

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.09, 0.09]

6.5 Calcipotriol (6 wks) vs. calcipotriol OM, fluocinonide acetonide ON (2 wks); then calcipotriol twice daily (4 wks)

1

38

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.10, 0.10]

6.6 Calcipotriol (6 wks) vs. halometasone OM, calcipotriol ON (2 wks); then calcipotriol twice daily (w/dy), halometasone (w/e) (2 wks); then calcipotriol twice daily (2 wks)

1

76

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.05, 0.05]

6.7 Calcipotriol ON, clobetasol propionate OM (2 to 4 wks); then calcipotriol twice daily (to wk 12) vs. calcitriol ON, clobetasol propionate OM (2 to 4 wks); then calcitriol twice daily (to wk 12)

1

125

Risk Difference (M‐H, Random, 95% CI)

‐0.01 [‐0.12, 0.11]

6.8 Combined calcipotriol + BMD (4 wks); then placebo ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol ointment twice daily (8 wks)

1

759

Risk Difference (M‐H, Random, 95% CI)

0.08 [0.03, 0.14]

6.9 Combined calcipotriol + BMD (4 wks); then placebo ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) + combined calcipotriol + BMD (w/e) (8 wks)

1

753

Risk Difference (M‐H, Random, 95% CI)

0.11 [0.06, 0.17]

6.10 Combined calcipotriol + BMD (4 wks); then calcipotriol ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) + combined calcipotriol + BMD (w/e) (8 wks)

1

760

Risk Difference (M‐H, Random, 95% CI)

0.03 [‐0.01, 0.07]

6.11 Combined calcipotriol + BMD (8 wks); then calcipotriol (4 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) & combined calcipotriol + BMD (w/e) (8 wks)

1

644

Risk Difference (M‐H, Random, 95% CI)

0.03 [‐0.01, 0.07]

6.12 Tacalcitol (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks)

1

501

Risk Difference (M‐H, Random, 95% CI)

0.05 [‐0.01, 0.12]

7 Withdrawals due to adverse events Show forest plot

8

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

7.1 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (8 wks); then calcipotriol (4 wks)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.2 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (8 wks)

1

150

Risk Difference (M‐H, Random, 95% CI)

‐0.04 [‐0.09, 0.01]

7.3 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) & combined calcipotriol + BMD (w/e) (8 wks)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.4 Calcipotriol (6 wks) vs. clobetasol propionate (2 wks); then calcipotriol (4 wks)

1

98

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.04, 0.04]

7.5 Calcipotriol (6 wks) vs. calcipotriol OM, fluocinonide acetonide ON (2 wks); then calcipotriol twice daily (4 wks)

1

38

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.10, 0.10]

7.6 Calcipotriol (6 wks) vs. halometasone OM, calcipotriol ON (2 wks); then calcipotriol twice daily (w/dy), halometasone (w/e) (2 wks); then calcipotriol twice daily (2 wks)

1

76

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.05, 0.05]

7.7 Calcipotriol ON, clobetasol propionate OM (2 to 4 wks); then calcipotriol twice daily (to wk 12) vs. calcitriol ON, clobetasol propionate OM (2 to 4 wks); then calcitriol twice daily (to wk 12)

1

125

Risk Difference (M‐H, Random, 95% CI)

‐0.02 [‐0.06, 0.03]

7.8 Combined calcipotriol + BMD (4 wks); then placebo ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol ointment twice daily (8 wks)

1

759

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.01, 0.02]

7.9 Combined calcipotriol + BMD (4 wks); then placebo ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) + combined calcipotriol + BMD (w/e) (8 wks)

1

753

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.02, 0.02]

7.10 Combined calcipotriol + BMD (4 wks); then calcipotriol ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) + combined calcipotriol + BMD (w/e) (8 wks)

1

760

Risk Difference (M‐H, Random, 95% CI)

‐0.01 [‐0.03, 0.01]

7.11 Combined calcipotriol + BMD (8 wks); then calcipotriol (4 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) & combined calcipotriol + BMD (w/e) (8 wks)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.12 Tacalcitol (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks)

1

501

Risk Difference (M‐H, Random, 95% CI)

0.02 [‐0.01, 0.05]

8 Withdrawals due to treatment failure Show forest plot

6

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

8.1 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (8 wks); then calcipotriol (4 wks)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.2 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (8 wks)

1

150

Risk Difference (M‐H, Random, 95% CI)

0.21 [0.10, 0.33]

8.3 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) & combined calcipotriol + BMD (w/e) (8 wks)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.4 Calcipotriol (6 wks) vs. clobetasol propionate (2 wks); then calcipotriol (4 wks)

1

98

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.04, 0.04]

8.5 Calcipotriol (6 wks) vs. calcipotriol OM, fluocinonide acetonide ON (2 wks); then calcipotriol twice daily (4 wks)

1

38

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.10, 0.10]

8.6 Calcipotriol (6 wks) vs. halometasone OM, calcipotriol ON (2 wks); then calcipotriol twice daily (w/dy), halometasone (w/e) (2 wks); then calcipotriol twice daily (2 wks)

1

76

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.05, 0.05]

8.7 Calcipotriol ON, clobetasol propionate OM (2 to 4 wks); then calcipotriol twice daily (to wk 12) vs. calcitriol ON, clobetasol propionate OM (2 to 4 wks); then calcitriol twice daily (to wk 12)

1

125

Risk Difference (M‐H, Random, 95% CI)

0.03 [‐0.04, 0.10]

8.8 Combined calcipotriol + BMD (4 wks); then placebo ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol ointment twice daily (8 wks)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.9 Combined calcipotriol + BMD (4 wks); then placebo ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) + combined calcipotriol + BMD (w/e) (8 wks)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.10 Combined calcipotriol + BMD (4 wks); then calcipotriol ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy)+ combined calcipotriol + BMD (w/e) (8 wks)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.11 Combined calcipotriol + BMD (8 wks); then calcipotriol (4 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) & combined calcipotriol + BMD (w/e) (8 wks)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.12 Tacalcitol (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks)

1

501

Risk Difference (M‐H, Random, 95% CI)

0.05 [0.02, 0.08]

9 Adverse events (local) Show forest plot

8

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

9.1 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (8 wks); then calcipotriol (4 wks)

1

649

Risk Difference (M‐H, Random, 95% CI)

0.11 [0.06, 0.17]

9.2 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (8 wks)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.3 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) & combined calcipotriol + BMD (w/e) (8 wks)

1

649

Risk Difference (M‐H, Random, 95% CI)

0.11 [0.05, 0.17]

9.4 Calcipotriol (6 wks) vs. clobetasol propionate (2 wks); then calcipotriol (4 wks)

1

98

Risk Difference (M‐H, Random, 95% CI)

0.02 [‐0.08, 0.12]

9.5 Calcipotriol (6 wks) vs. calcipotriol OM, fluocinonide acetonide ON (2 wks); then calcipotriol twice daily (4 wks)

1

38

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.14, 0.14]

9.6 Calcipotriol (6 wks) vs. halometasone OM, calcipotriol ON (2 wks); then calcipotriol twice daily (w/dy), halometasone (w/e) (2 wks); then calcipotriol twice daily (2 wks)

1

76

Risk Difference (M‐H, Random, 95% CI)

0.26 [0.07, 0.45]

9.7 Calcipotriol ON, clobetasol propionate OM (2 to 4 wks); then calcipotriol twice daily (to wk 12) vs. calcitriol ON, clobetasol propionate OM (2 to 4 wks); then calcitriol twice daily (to wk 12)

1

125

Risk Difference (M‐H, Random, 95% CI)

‐0.02 [‐0.10, 0.06]

9.8 Combined calcipotriol + BMD (4 wks); then placebo ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol ointment twice daily (8 wks)

1

752

Risk Difference (M‐H, Random, 95% CI)

‐0.03 [‐0.07, 0.02]

9.9 Combined calcipotriol + BMD (4 wks); then placebo ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) + combined calcipotriol + BMD (w/e) (8 wks)

1

743

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.03, 0.05]

9.10 Combined calcipotriol + BMD (4 wks); then calcipotriol ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) + combined calcipotriol + BMD (w/e) (8 wks)

1

749

Risk Difference (M‐H, Random, 95% CI)

0.04 [‐0.00, 0.08]

9.11 Combined calcipotriol + BMD (8 wks); then calcipotriol (4 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) & combined calcipotriol + BMD (w/e) (8 wks)

1

644

Risk Difference (M‐H, Random, 95% CI)

‐0.01 [‐0.05, 0.04]

9.12 Tacalcitol (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks)

1

501

Risk Difference (M‐H, Random, 95% CI)

0.06 [0.01, 0.11]

10 Adverse events (systemic)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.1 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (8 wks); then calcipotriol (4 wks)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.2 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (8 wks)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.3 Calcipotriol (12 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) & combined calcipotriol + BMD (w/e) (8 wks)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.4 Calcipotriol (6 wks) vs. clobetasol propionate (2 wks); then calcipotriol (4 wks)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.5 Calcipotriol (6 wks) vs. calcipotriol OM, fluocinonide acetonide ON (2 wks); then calcipotriol twice daily (4 wks)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.6 Calcipotriol (6 wks) vs. halometasone OM, calcipotriol ON (2 wks); then calcipotriol twice daily (w/dy), halometasone (w/e) (2 wks); then calcipotriol twice daily (2 wks)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.7 Calcipotriol ON, clobetasol propionate OM (2 to 4 wks); then calcipotriol twice daily (to wk 12) vs. calcitriol ON, clobetasol propionate OM (2 to 4 wks); then calcitriol twice daily (to wk 12)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.8 Combined calcipotriol + BMD (4 wks); then placebo ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol ointment twice daily (8 wks)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.9 Combined calcipotriol + BMD (4 wks); then placebo ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) + combined calcipotriol + BMD (w/e) (8 wks)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.10 Combined calcipotriol + BMD (4 wks); then calcipotriol ointment twice daily (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) + combined calcipotriol + BMD (w/e) (8 wks)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.11 Combined calcipotriol + BMD (8 wks); then calcipotriol (4 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (w/dy) & combined calcipotriol + BMD (w/e) (8 wks)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.12 Tacalcitol (8 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 13. Vitamin D alone or in combination versus other treatments: complex regimens
Comparison 14. Vitamin D alone or in combination versus other treatment: long‐term studies (> 24 wks)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 IAGI Show forest plot

1

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

1.1 Combined calcipotriol + BMD (52 wks) vs. alternating: combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks)

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 Combined calcipotriol + BMD (52 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (48 wks)

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 Alternating: combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (48 wks)

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2 TSS

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.1 Combined calcipotriol + BMD (52 wks) vs. alternating: combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 Combined calcipotriol + BMD (52 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (48 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.3 Alternating: combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (48 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3 PASI

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.1 Combined calcipotriol + BMD (52 wks) vs. alternating: combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.2 Combined calcipotriol + BMD (52 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (48 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.3 Alternating: combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (48 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4 PAGI

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.1 Combined calcipotriol + BMD (52 wks) vs. alternating: combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.2 Combined calcipotriol + BMD (52 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (48 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.3 Alternating: combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (48 wks)

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5 Combined end point (IAGI/TSS/PASI/PAGI) Show forest plot

1

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

5.1 Combined calcipotriol + BMD (52 wks) vs. alternating: combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks)

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5.2 Combined calcipotriol + BMD (52 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (48 wks)

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5.3 Alternating: combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (48 wks)

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

6 Total withdrawals Show forest plot

1

Risk Difference (M‐H, Random, 95% CI)

Totals not selected

6.1 Combined calcipotriol + BMD (52 wks) vs. alternating: combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks)

1

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.2 Combined calcipotriol + BMD (52 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (48 wks)

1

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.3 Alternating: combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (48 wks)

1

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7 Withdrawals due to adverse events Show forest plot

1

Risk Difference (M‐H, Random, 95% CI)

Totals not selected

7.1 Combined calcipotriol + BMD (52 wks) vs. alternating: combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks)

1

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.2 Combined calcipotriol + BMD (52 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (48 wks)

1

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.3 Alternating: combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (48 wks)

1

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8 Withdrawals due to treatment failure Show forest plot

1

Risk Difference (M‐H, Random, 95% CI)

Totals not selected

8.1 Combined calcipotriol + BMD (52 wks) vs. alternating: combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks)

1

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.2 Combined calcipotriol + BMD (52 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (48 wks)

1

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.3 Alternating: combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (48 wks)

1

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9 Adverse events (local) Show forest plot

1

Risk Difference (M‐H, Random, 95% CI)

Totals not selected

9.1 Combined calcipotriol + BMD (52 wks) vs. alternating: combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks)

1

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.2 Combined calcipotriol + BMD (52 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (48 wks)

1

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.3 Alternating: combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (48 wks)

1

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10 Adverse events (systemic)

0

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

10.1 Combined calcipotriol + BMD (52 wks) vs. alternating: combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.2 Combined calcipotriol + BMD (52 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (48 wks)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.3 Alternating: combined calcipotriol + BMD (4 wks); then calcipotriol (4 wks) vs. combined calcipotriol + BMD (4 wks); then calcipotriol (48 wks)

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 14. Vitamin D alone or in combination versus other treatment: long‐term studies (> 24 wks)
Comparison 15. Vitamin D analogues versus other treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 IAGI Show forest plot

10

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 Calcipotriol vs. coal tar

3

139

Std. Mean Difference (IV, Random, 95% CI)

‐0.53 [‐1.74, 0.68]

1.2 Calcipotriol vs. coal tar polytherapy

2

209

Std. Mean Difference (IV, Random, 95% CI)

‐0.59 [‐0.87, ‐0.31]

1.3 Calcipotriol vs. nicotinamide 1.4%, twice daily

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.4 Calcipotriol vs. calcipotriol + nicotinamide 1.4%, twice daily

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.5 Calcipotriol vs. corticosteroid + salicylic acid

1

200

Std. Mean Difference (IV, Random, 95% CI)

‐0.06 [‐0.33, 0.22]

1.6 Calcipotriol vs. propylthiouracil cream

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.7 Calcipotriol vs. tazarotene

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.8 Calcipotriol vs. tacrolimus ointment

1

124

Std. Mean Difference (IV, Random, 95% CI)

‐0.22 [‐0.60, 0.16]

1.9 Calcipotriol vs. tazarotene gel plus mometasone furoate cream

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.10 Calcipotriol vs. vitamin B12 cream

1

26

Std. Mean Difference (IV, Random, 95% CI)

‐0.55 [‐1.33, 0.24]

1.11 Head‐to‐head vitamin D alone or in combination: twice daily vs OD

2

728

Std. Mean Difference (IV, Random, 95% CI)

‐0.24 [‐0.38, ‐0.09]

1.12 Head‐to‐head vitamin D alone or in combination: no occlusion vs. occlusion

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2 TSS Show forest plot

7

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

2.1 Calcipotriol vs. coal tar

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 Calcipotriol vs. coal tar polytherapy

1

132

Std. Mean Difference (IV, Random, 95% CI)

‐0.51 [‐0.86, ‐0.16]

2.3 Calcipotriol vs. nicotinamide 1.4%, twice daily

1

96

Std. Mean Difference (IV, Random, 95% CI)

‐0.09 [‐0.49, 0.31]

2.4 Calcipotriol vs. calcipotriol+nicotinamide (0.05%, 0.1%, 0.7%, or 1.4%), twice daily

1

192

Std. Mean Difference (IV, Random, 95% CI)

0.19 [‐0.14, 0.52]

2.5 Calcipotriol vs. corticosteroid + salicylic acid

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.6 Calcipotriol vs. propylthiouracil cream

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.7 Calcipotriol vs. tacrolimus ointment

2

171

Std. Mean Difference (IV, Random, 95% CI)

‐0.35 [‐1.51, 0.81]

2.8 Calcipotriol vs. tazarotene

1

199

Std. Mean Difference (IV, Random, 95% CI)

‐0.05 [‐0.33, 0.23]

2.9 Calcipotriol vs. tazarotene gel plus mometasone furoate cream

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.10 Calcipotriol vs. vitamin B12 cream

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.11 Head‐to‐head vitamin D alone or in combination: twice daily vs OD

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.12 Head‐to‐head vitamin D alone or in combination: no occlusion vs. occlusion

2

247

Std. Mean Difference (IV, Random, 95% CI)

‐0.18 [‐2.04, 1.68]

3 PASI Show forest plot

9

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

3.1 Calcipotriol vs. coal tar

2

109

Std. Mean Difference (IV, Random, 95% CI)

‐0.10 [‐1.54, 1.35]

3.2 Calcipotriol vs. coal tar polytherapy

1

87

Std. Mean Difference (IV, Random, 95% CI)

‐0.63 [‐1.06, ‐0.20]

3.3 Calcipotriol vs. nicotinamide 1.4%, twice daily

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.4 Calcipotriol vs. calcipotriol + nicotinamide 1.4%, twice daily

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.5 Calcipotriol vs. corticosteroid + salicylic acid

1

160

Std. Mean Difference (IV, Random, 95% CI)

‐0.05 [‐0.36, 0.26]

3.6 Calcipotriol vs. propylthiouracil cream

1

27

Std. Mean Difference (IV, Random, 95% CI)

‐2.24 [‐3.23, ‐1.25]

3.7 Calcipotriol vs. tacrolimus ointment

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.8 Calcipotriol vs. tazarotene

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.9 Calcipotriol vs. tazarotene gel plus mometasone furoate cream

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.10 Calcipotriol vs. vitamin B12 cream

1

26

Std. Mean Difference (IV, Random, 95% CI)

‐0.01 [‐0.78, 0.75]

3.11 Head‐to‐head vitamin D alone or in combination: twice daily vs OD

3

989

Std. Mean Difference (IV, Random, 95% CI)

‐0.12 [‐0.25, 0.00]

3.12 Head‐to‐head vitamin D alone or in combination: no occlusion vs. occlusion

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4 PAGI Show forest plot

6

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

4.1 Calcipotriol vs. coal tar

1

54

Std. Mean Difference (IV, Random, 95% CI)

‐1.51 [‐2.12, ‐0.90]

4.2 Calcipotriol vs. coal tar polytherapy

1

87

Std. Mean Difference (IV, Random, 95% CI)

‐0.56 [‐0.99, ‐0.13]

4.3 Calcipotriol vs. nicotinamide 1.4%, twice daily

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.4 Calcipotriol vs. calcipotriol + nicotinamide 1.4%, twice daily

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.5 Calcipotriol vs. corticosteroid + salicylic acid

1

186

Std. Mean Difference (IV, Random, 95% CI)

‐0.49 [‐0.79, ‐0.20]

4.6 Calcipotriol vs. propylthiouracil cream

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.7 Calcipotriol vs. tacrolimus ointment

1

124

Std. Mean Difference (IV, Random, 95% CI)

‐0.13 [‐0.51, 0.24]

4.8 Calcipotriol vs. tazarotene

1

38

Std. Mean Difference (IV, Random, 95% CI)

‐0.35 [‐0.99, 0.29]

4.9 Calcipotriol vs. tazarotene gel plus mometasone furoate cream

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.10 Calcipotriol vs. vitamin B12 cream

1

26

Std. Mean Difference (IV, Random, 95% CI)

‐0.55 [‐1.33, 0.24]

4.11 Head‐to‐head vitamin D alone or in combination: twice daily vs OD

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.12 Head‐to‐head vitamin D alone or in combination: no occlusion vs. occlusion

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5 Combined end point (IAGI/TSS/PASI/PAGI) Show forest plot

19

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

5.1 Calcipotriol vs. coal tar

3

139

Std. Mean Difference (IV, Random, 95% CI)

‐0.53 [‐1.74, 0.68]

5.2 Calcipotriol vs. coal tar polytherapy

2

209

Std. Mean Difference (IV, Random, 95% CI)

‐0.59 [‐0.87, ‐0.31]

5.3 Calcipotriol vs. nicotinamide 1.4%, twice daily

1

96

Std. Mean Difference (IV, Random, 95% CI)

‐0.09 [‐0.49, 0.31]

5.4 Calcipotriol vs. calcipotriol + nicotinamide (0.05%, 0.1%, 0.7%, or 1.4%), twice daily

1

192

Std. Mean Difference (IV, Random, 95% CI)

0.19 [‐0.14, 0.52]

5.5 Calcipotriol vs. corticosteroid + salicylic acid

2

360

Std. Mean Difference (IV, Random, 95% CI)

‐0.05 [‐0.26, 0.15]

5.6 Calcipotriol vs. propylthiouracil cream

1

27

Std. Mean Difference (IV, Random, 95% CI)

‐2.24 [‐3.23, ‐1.25]

5.7 Calcipotriol vs. tacrolimus ointment

2

171

Std. Mean Difference (IV, Random, 95% CI)

‐0.55 [‐1.28, 0.17]

5.8 Calcipotriol vs. tazarotene

2

237

Std. Mean Difference (IV, Random, 95% CI)

‐0.10 [‐0.35, 0.16]

5.9 Calcipotriol vs. tazarotene gel plus mometasone furoate cream

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5.10 Calcipotriol vs. vitamin B12 cream

1

26

Std. Mean Difference (IV, Random, 95% CI)

‐0.55 [‐1.33, 0.24]

5.11 Head‐to‐head vitamin D alone or in combination: twice daily vs OD

3

988

Std. Mean Difference (IV, Random, 95% CI)

‐0.20 [‐0.32, ‐0.07]

5.12 Head‐to‐head vitamin D alone or in combination: no occlusion vs. occlusion

2

247

Std. Mean Difference (IV, Random, 95% CI)

‐0.18 [‐2.04, 1.68]

6 Total withdrawals Show forest plot

15

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

6.1 Calcipotriol vs. coal tar

2

120

Risk Difference (M‐H, Random, 95% CI)

‐0.02 [‐0.12, 0.08]

6.2 Calcipotriol vs. coal tar polytherapy

2

220

Risk Difference (M‐H, Random, 95% CI)

‐0.03 [‐0.10, 0.04]

6.3 Calcipotriol vs. nicotinamide 1.4%, twice daily

1

96

Risk Difference (M‐H, Random, 95% CI)

0.02 [‐0.05, 0.09]

6.4 Calcipotriol vs. calcipotriol + nicotinamide (0.05%, 0.1%, 0.7%, or 1.4%), twice daily

1

192

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.06, 0.07]

6.5 Calcipotriol vs. corticosteroid + salicylic acid

1

160

Risk Difference (M‐H, Random, 95% CI)

0.04 [‐0.09, 0.17]

6.6 Calcipotriol vs. propylthiouracil cream

1

28

Risk Difference (M‐H, Random, 95% CI)

0.07 [‐0.16, 0.30]

6.7 Calcipotriol vs. tacrolimus ointment

1

124

Risk Difference (M‐H, Random, 95% CI)

‐0.13 [‐0.25, ‐0.01]

6.8 Calcipotriol vs. tazarotene

2

254

Risk Difference (M‐H, Random, 95% CI)

‐0.04 [‐0.10, 0.01]

6.9 Calcipotriol vs. tazarotene gel plus mometasone furoate cream

1

120

Risk Difference (M‐H, Random, 95% CI)

‐0.03 [‐0.15, 0.08]

6.10 Calcipotriol vs. vitamin B12 cream

1

26

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.14, 0.14]

6.11 Head‐to‐head vitamin D alone or in combination: twice daily vs OD

3

1001

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.03, 0.05]

6.12 Head‐to‐head vitamin D alone or in combination: no occlusion vs. occlusion

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7 Withdrawals due to adverse events Show forest plot

15

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

7.1 Calcipotriol vs. coal tar

2

120

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.04, 0.06]

7.2 Calcipotriol vs. coal tar polytherapy

2

210

Risk Difference (M‐H, Random, 95% CI)

‐0.02 [‐0.07, 0.03]

7.3 Calcipotriol vs. nicotinamide 1.4%, twice daily

1

96

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.04, 0.04]

7.4 Calcipotriol vs. calcipotriol + nicotinamide (0.05%, 0.1%, 0.7%, or 1.4%), twice daily

1

192

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.03, 0.03]

7.5 Calcipotriol vs. corticosteroid + salicylic acid

1

160

Risk Difference (M‐H, Random, 95% CI)

0.05 [‐0.00, 0.10]

7.6 Calcipotriol vs. propylthiouracil cream

1

28

Risk Difference (M‐H, Random, 95% CI)

0.07 [‐0.16, 0.30]

7.7 Calcipotriol vs. tacrolimus ointment

1

124

Risk Difference (M‐H, Random, 95% CI)

0.02 [‐0.08, 0.11]

7.8 Calcipotriol vs. tazarotene

2

254

Risk Difference (M‐H, Random, 95% CI)

‐0.05 [‐0.16, 0.05]

7.9 Calcipotriol vs. tazarotene gel plus mometasone furoate cream

1

120

Risk Difference (M‐H, Random, 95% CI)

‐0.02 [‐0.10, 0.07]

7.10 Calcipotriol vs. vitamin B12 cream

1

26

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.14, 0.14]

7.11 Head‐to‐head vitamin D alone or in combination: twice daily vs OD

3

998

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.01, 0.02]

7.12 Head‐to‐head vitamin D alone or in combination: no occlusion vs. occlusion

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8 Withdrawals due to treatment failure Show forest plot

12

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

8.1 Calcipotriol vs. coal tar

1

60

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.06, 0.06]

8.2 Calcipotriol vs. coal tar polytherapy

1

88

Risk Difference (M‐H, Random, 95% CI)

0.00 [‐0.06, 0.07]

8.3 Calcipotriol vs. nicotinamide 1.4%, twice daily

1

96

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.04, 0.04]

8.4 Calcipotriol vs. calcipotriol + nicotinamide (0.05%, 0.1%, 0.7%, or 1.4%), twice daily

1

192

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.03, 0.03]

8.5 Calcipotriol vs. corticosteroid + salicylic acid

1

160

Risk Difference (M‐H, Random, 95% CI)

‐0.02 [‐0.07, 0.02]

8.6 Calcipotriol vs. propylthiouracil cream

1

28

Risk Difference (M‐H, Random, 95% CI)

‐0.07 [‐0.25, 0.11]

8.7 Calcipotriol vs. tacrolimus ointment

1

124

Risk Difference (M‐H, Random, 95% CI)

‐0.02 [‐0.07, 0.03]

8.8 Calcipotriol vs. tazarotene

1

208

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.02, 0.02]

8.9 Calcipotriol vs. tazarotene gel plus mometasone furoate cream

1

120

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.05, 0.05]

8.10 Calcipotriol vs. vitamin B12 cream

1

26

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.14, 0.14]

8.11 Head‐to‐head vitamin D alone or in combination: twice daily vs OD

3

998

Risk Difference (M‐H, Random, 95% CI)

0.00 [‐0.01, 0.01]

8.12 Head‐to‐head vitamin D alone or in combination: no occlusion vs. occlusion

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9 Adverse events (local) Show forest plot

11

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

9.1 Calcipotriol vs. coal tar

2

120

Risk Difference (M‐H, Random, 95% CI)

0.02 [‐0.06, 0.10]

9.2 Calcipotriol vs. coal tar polytherapy

1

122

Risk Difference (M‐H, Random, 95% CI)

0.06 [‐0.09, 0.20]

9.3 Calcipotriol vs. nicotinamide 1.4%, twice daily

1

96

Risk Difference (M‐H, Random, 95% CI)

‐0.15 [‐0.32, 0.03]

9.4 Calcipotriol vs. calcipotriol + nicotinamide (0.05%, 0.1%, 0.7%, or 1.4%), twice daily

1

192

Risk Difference (M‐H, Random, 95% CI)

‐0.17 [‐0.30, ‐0.03]

9.5 Calcipotriol vs. corticosteroid + salicylic acid

1

160

Risk Difference (M‐H, Random, 95% CI)

0.09 [0.02, 0.15]

9.6 Calcipotriol vs. propylthiouracil cream

1

28

Risk Difference (M‐H, Random, 95% CI)

‐0.07 [‐0.25, 0.11]

9.7 Calcipotriol vs. tacrolimus ointment

1

124

Risk Difference (M‐H, Random, 95% CI)

‐0.19 [‐0.37, ‐0.01]

9.8 Calcipotriol vs. tazarotene

1

204

Risk Difference (M‐H, Random, 95% CI)

‐0.03 [‐0.11, 0.06]

9.9 Calcipotriol vs. tazarotene gel plus mometasone furoate cream

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.10 Calcipotriol vs. vitamin B12 cream

1

26

Risk Difference (M‐H, Random, 95% CI)

0.23 [‐0.06, 0.52]

9.11 Head‐to‐head vitamin D alone or in combination: twice daily vs OD

2

731

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.06, 0.05]

9.12 Head‐to‐head vitamin D alone or in combination: no occlusion vs. occlusion

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10 Adverse events (systemic) Show forest plot

8

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

10.1 Calcipotriol vs. coal tar

1

60

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.09, 0.09]

10.2 Calcipotriol vs. coal tar polytherapy

1

88

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.04, 0.04]

10.3 Calcipotriol vs. nicotinamide 1.4%, twice daily

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.4 Calcipotriol vs. calcipotriol + nicotinamide 1.4%, twice daily

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.5 Calcipotriol vs. corticosteroid + salicylic acid

1

160

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.02, 0.02]

10.6 Calcipotriol vs. propylthiouracil cream

1

28

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.13, 0.13]

10.7 Calcipotriol vs. tacrolimus ointment

1

124

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.04, 0.04]

10.8 Calcipotriol vs. tazarotene

1

183

Risk Difference (M‐H, Random, 95% CI)

‐0.01 [‐0.05, 0.03]

10.9 Calcipotriol vs. tazarotene gel plus mometasone furoate cream

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.10 Calcipotriol vs. vitamin B12 cream

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.11 Head‐to‐head vitamin D alone or in combination: twice daily vs OD

1

264

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.01, 0.01]

10.12 Head‐to‐head vitamin D alone or in combination: no occlusion vs. occlusion

1

38

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.10, 0.10]

Figures and Tables -
Comparison 15. Vitamin D analogues versus other treatment
Comparison 16. Flexural/facial psoriasis: placebo‐controlled trials

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 IAGI Show forest plot

1

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

1.1 Betamethasone valerate 0.1%, OD

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 Calcipotriol ointment, OD

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 Pimecrolimus cream, 1% OD/twice daily

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.4 Tacrolimus ointment 0.1%, twice daily

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2 TSS Show forest plot

1

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

2.1 Betamethasone valerate 0.1%, OD

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 Calcipotriol ointment, OD

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.3 Pimecrolimus cream, 1% OD/twice daily

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.4 Tacrolimus ointment 0.1%, twice daily

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3 PASI Show forest plot

1

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

3.1 Betamethasone valerate 0.1%, OD

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.2 Calcipotriol ointment, OD

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.3 Pimecrolimus cream, 1% OD/twice daily

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.4 Tacrolimus ointment 0.1%, twice daily

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4 PAGI Show forest plot

1

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

4.1 Betamethasone valerate 0.1%, OD

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.2 Calcipotriol ointment, OD

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.3 Pimecrolimus cream, 1% OD/twice daily

1

47

Std. Mean Difference (IV, Random, 95% CI)

‐0.65 [‐1.24, ‐0.06]

4.4 Tacrolimus ointment 0.1%, twice daily

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5 Combined end point (IAGI/TSS/PASI/PAGI) Show forest plot

2

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

5.1 Betamethasone valerate 0.1%, OD

1

36

Std. Mean Difference (IV, Random, 95% CI)

‐2.83 [‐3.79, ‐1.88]

5.2 Calcipotriol ointment, OD

1

38

Std. Mean Difference (IV, Random, 95% CI)

‐1.08 [‐1.77, ‐0.40]

5.3 Pimecrolimus cream, 1% OD/twice daily

2

86

Std. Mean Difference (IV, Random, 95% CI)

‐0.86 [‐1.30, ‐0.41]

5.4 Tacrolimus ointment 0.1%, twice daily

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

6 Total withdrawals Show forest plot

3

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

6.1 Betamethasone valerate 0.1%, OD

1

40

Risk Difference (M‐H, Random, 95% CI)

0.10 [‐0.08, 0.28]

6.2 Calcipotriol ointment, OD

1

40

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.14, 0.14]

6.3 Pimecrolimus cream, 1% OD/twice daily

2

97

Risk Difference (M‐H, Random, 95% CI)

‐0.06 [‐0.16, 0.04]

6.4 Tacrolimus ointment 0.1%, twice daily

1

167

Risk Difference (M‐H, Random, 95% CI)

‐0.17 [‐0.30, ‐0.03]

7 Withdrawals due to adverse events Show forest plot

3

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

7.1 Betamethasone valerate 0.1%, OD

1

40

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.09, 0.09]

7.2 Calcipotriol ointment, OD

1

40

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.09, 0.09]

7.3 Pimecrolimus cream, 1% OD/twice daily

2

97

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.05, 0.05]

7.4 Tacrolimus ointment 0.1%, twice daily

1

167

Risk Difference (M‐H, Random, 95% CI)

‐0.02 [‐0.06, 0.03]

8 Withdrawals due to treatment failure Show forest plot

3

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

8.1 Betamethasone valerate 0.1%, OD

1

40

Risk Difference (M‐H, Random, 95% CI)

‐0.05 [‐0.18, 0.08]

8.2 Calcipotriol ointment, OD

1

40

Risk Difference (M‐H, Random, 95% CI)

‐0.05 [‐0.18, 0.08]

8.3 Pimecrolimus cream, 1% OD/twice daily

2

97

Risk Difference (M‐H, Random, 95% CI)

‐0.04 [‐0.13, 0.04]

8.4 Tacrolimus ointment 0.1%, twice daily

1

167

Risk Difference (M‐H, Random, 95% CI)

‐0.11 [‐0.19, ‐0.02]

9 Adverse events (local) Show forest plot

3

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

9.1 Betamethasone valerate 0.1%, OD

1

40

Risk Difference (M‐H, Random, 95% CI)

‐0.05 [‐0.18, 0.08]

9.2 Calcipotriol ointment, OD

1

40

Risk Difference (M‐H, Random, 95% CI)

0.05 [‐0.11, 0.21]

9.3 Pimecrolimus cream 1%, OD/twice daily

2

97

Risk Difference (M‐H, Random, 95% CI)

0.08 [‐0.15, 0.31]

9.4 Tacrolimus ointment 0.1%, twice daily

1

167

Risk Difference (M‐H, Random, 95% CI)

‐0.17 [‐0.30, ‐0.03]

10 Adverse events (systemic) Show forest plot

1

Risk Difference (M‐H, Random, 95% CI)

Totals not selected

10.1 Betamethasone valerate 0.1%, OD

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.2 Calcipotriol ointment, OD

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.3 Pimecrolimus cream 1%, OD/twice daily

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.4 Tacrolimus ointment 0.1%, twice daily

1

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 16. Flexural/facial psoriasis: placebo‐controlled trials
Comparison 17. Flexural/facial psoriasis: vitamin D alone or in combination versus other treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 IAGI Show forest plot

2

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 Calcipotriol vs. BMV

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 Calcipotriol vs. calcipotriol + hydrocortisone

1

408

Std. Mean Difference (IV, Random, 95% CI)

0.30 [0.11, 0.50]

1.3 Calcipotriol vs. calcitriol

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.4 Calcipotriol vs. pimecrolimus

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.5 Calcitriol vs. tacrolimus

1

49

Std. Mean Difference (IV, Random, 95% CI)

0.42 [‐0.15, 0.98]

2 TSS Show forest plot

2

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

2.1 Calcipotriol vs. BMV

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 Calcipotriol vs. calcipotriol + hydrocortisone

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.3 Calcipotriol vs. calcitriol

1

150

Std. Mean Difference (IV, Random, 95% CI)

0.61 [0.28, 0.94]

2.4 Calcipotriol vs. pimecrolimus

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.5 Calcitriol vs. tacrolimus

1

49

Std. Mean Difference (IV, Random, 95% CI)

0.29 [‐0.27, 0.85]

3 PASI Show forest plot

2

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

3.1 Calcipotriol vs. BMV

1

36

Std. Mean Difference (IV, Random, 95% CI)

2.02 [1.20, 2.84]

3.2 Calcipotriol vs. calcipotriol + hydrocortisone

1

408

Std. Mean Difference (IV, Random, 95% CI)

0.32 [0.12, 0.51]

3.3 Calcipotriol vs. calcitriol

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.4 Calcipotriol vs. pimecrolimus

1

39

Std. Mean Difference (IV, Random, 95% CI)

‐0.53 [‐1.17, 0.11]

3.5 Calcitriol vs. tacrolimus

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4 PAGI

0

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

4.1 Calcipotriol vs. BMV

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.2 Calcipotriol vs. calcipotriol + hydrocortisone

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.3 Calcipotriol vs. calcitriol

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.4 Calcipotriol vs. pimecrolimus

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.5 Calcitriol vs. tacrolimus

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5 Combined end point (IAGI/TSS/PASI/PAGI) Show forest plot

4

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

5.1 Calcipotriol vs. BMV

1

36

Std. Mean Difference (IV, Random, 95% CI)

2.02 [1.20, 2.84]

5.2 Calcipotriol vs. calcipotriol + hydrocortisone

1

408

Std. Mean Difference (IV, Random, 95% CI)

0.30 [0.11, 0.50]

5.3 Calcipotriol vs. calcitriol

1

150

Std. Mean Difference (IV, Random, 95% CI)

0.61 [0.28, 0.94]

5.4 Calcipotriol vs. pimecrolimus

1

39

Std. Mean Difference (IV, Random, 95% CI)

‐0.53 [‐1.17, 0.11]

5.5 Calcitriol vs. tacrolimus

1

49

Std. Mean Difference (IV, Random, 95% CI)

0.42 [‐0.15, 0.98]

6 Total withdrawals Show forest plot

4

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

6.1 Calcipotriol vs. BMV

1

40

Risk Difference (M‐H, Random, 95% CI)

‐0.10 [‐0.28, 0.08]

6.2 Calcipotriol vs. calcipotriol + hydrocortisone

1

408

Risk Difference (M‐H, Random, 95% CI)

0.04 [‐0.03, 0.11]

6.3 Calcipotriol vs. calcitriol

1

150

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.11, 0.11]

6.4 Calcipotriol vs. pimecrolimus

1

40

Risk Difference (M‐H, Random, 95% CI)

0.05 [‐0.08, 0.18]

6.5 Calcitriol vs. tacrolimus

1

50

Risk Difference (M‐H, Random, 95% CI)

0.12 [‐0.02, 0.26]

7 Withdrawals due to adverse events Show forest plot

4

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

7.1 Calcipotriol vs. BMV

1

40

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.09, 0.09]

7.2 Calcipotriol vs. calcipotriol + hydrocortisone

1

408

Risk Difference (M‐H, Random, 95% CI)

0.06 [0.02, 0.11]

7.3 Calcipotriol vs. calcitriol

1

150

Risk Difference (M‐H, Random, 95% CI)

0.09 [0.01, 0.18]

7.4 Calcipotriol vs. pimecrolimus

1

40

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.09, 0.09]

7.5 Calcitriol vs. tacrolimus

1

50

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.07, 0.07]

8 Withdrawals due to treatment failure Show forest plot

4

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

8.1 Calcipotriol vs. BMV

1

40

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.09, 0.09]

8.2 Calcipotriol vs. calcipotriol + hydrocortisone

1

408

Risk Difference (M‐H, Random, 95% CI)

0.02 [‐0.01, 0.05]

8.3 Calcipotriol vs. calcitriol

1

150

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.03, 0.03]

8.4 Calcipotriol vs. pimecrolimus

1

40

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.09, 0.09]

8.5 Calcitriol vs. tacrolimus

1

50

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.07, 0.07]

9 Adverse events (local) Show forest plot

3

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

9.1 calcipotriol vs. BMV

1

40

Risk Difference (M‐H, Random, 95% CI)

0.10 [‐0.05, 0.25]

9.2 Calcipotriol vs. calcipotriol + hydrocortisone

1

404

Risk Difference (M‐H, Random, 95% CI)

0.15 [0.08, 0.23]

9.3 Calcipotriol vs. calcitriol

1

150

Risk Difference (M‐H, Random, 95% CI)

0.09 [0.02, 0.17]

9.4 Calcipotriol vs. pimecrolimus

1

40

Risk Difference (M‐H, Random, 95% CI)

‐0.15 [‐0.38, 0.08]

9.5 Calcitriol vs. tacrolimus

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10 Adverse events (systemic)

0

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

10.1 Calcipotriol vs. BMV

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.2 Calcipotriol vs. calcipotriol + hydrocortisone

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.3 Calcipotriol vs. calcitriol

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.4 Calcipotriol vs. pimecrolimus

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.5 Calcitriol vs. tacrolimus

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 17. Flexural/facial psoriasis: vitamin D alone or in combination versus other treatment
Comparison 18. Scalp psoriasis: placebo‐controlled trials

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 IAGI Show forest plot

9

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 Vitamin D: calcipotriol

2

457

Std. Mean Difference (IV, Random, 95% CI)

‐0.72 [‐1.28, ‐0.16]

1.2 Potent steroid: betamethasone dipropionate

2

712

Std. Mean Difference (IV, Random, 95% CI)

‐1.09 [‐1.29, ‐0.90]

1.3 Potent steroid: betamethasone valerate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.4 Very potent steroid: amcinonide

1

132

Std. Mean Difference (IV, Random, 95% CI)

‐1.42 [‐1.80, ‐1.04]

1.5 Very potent steroid: clobetasol propionate

2

458

Std. Mean Difference (IV, Random, 95% CI)

‐1.73 [‐1.99, ‐1.48]

1.6 Very potent steroid: halcinonide

1

54

Std. Mean Difference (IV, Random, 95% CI)

‐1.11 [‐1.69, ‐0.53]

1.7 Vitamin D in combination: calcipotriol + BMD

2

854

Std. Mean Difference (IV, Random, 95% CI)

‐0.97 [‐1.61, ‐0.32]

1.8 Other treatment: betamethasone‐17,21‐dipropionate plus salicylic acid

1

20

Std. Mean Difference (IV, Random, 95% CI)

‐1.48 [‐2.50, ‐0.47]

1.9 Other treatment: ciclopirox olamine shampoo

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.10 Other treatment: fluocinolone acetonide, plus occlusion

1

84

Std. Mean Difference (IV, Random, 95% CI)

‐1.22 [‐1.69, ‐0.76]

1.11 Other treatment: salicylic acid

1

20

Std. Mean Difference (IV, Random, 95% CI)

‐0.86 [‐1.79, 0.06]

2 TSS Show forest plot

11

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

2.1 Vitamin D: calcipotriol

2

457

Std. Mean Difference (IV, Random, 95% CI)

‐0.44 [‐0.64, ‐0.25]

2.2 Potent steroid: betamethasone dipropionate

2

712

Std. Mean Difference (IV, Random, 95% CI)

‐1.00 [‐1.19, ‐0.81]

2.3 Potent steroid: betamethasone valerate

1

172

Std. Mean Difference (IV, Random, 95% CI)

‐1.40 [‐1.75, ‐1.05]

2.4 Very potent steroid: amcinonide

1

126

Std. Mean Difference (IV, Random, 95% CI)

‐1.58 [‐1.98, ‐1.18]

2.5 Very potent steroid: clobetasol propionate

3

707

Std. Mean Difference (IV, Random, 95% CI)

‐1.53 [‐1.77, ‐1.28]

2.6 Very potent steroid: halcinonide

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.7 Vitamin D in combination: calcipotriol + BMD

2

854

Std. Mean Difference (IV, Random, 95% CI)

‐0.92 [‐1.42, ‐0.43]

2.8 Other treatment: betamethasone‐17,21‐dipropionate plus salicylic acid

1

20

Std. Mean Difference (IV, Random, 95% CI)

‐1.15 [‐2.11, ‐0.19]

2.9 Other treatment: ciclopirox olamine shampoo

1

37

Std. Mean Difference (IV, Random, 95% CI)

‐0.07 [‐0.82, 0.68]

2.10 Other treatment: fluocinolone acetonide, plus occlusion

1

84

Std. Mean Difference (IV, Random, 95% CI)

‐0.89 [‐1.34, ‐0.44]

2.11 Other treatment: salicylic acid

1

20

Std. Mean Difference (IV, Random, 95% CI)

‐0.57 [‐1.47, 0.32]

3 PASI

0

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

3.1 Vitamin D: calcipotriol

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.2 Potent steroid: betamethasone dipropionate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.3 Potent steroid: betamethasone valerate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.4 Very potent steroid: amcinonide

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.5 Very potent steroid: clobetasol propionate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.6 Very potent steroid: halcinonide

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.7 Vitamin D in combination: calcipotriol + BMD

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.8 Other treatment: betamethasone‐17,21‐dipropionate plus salicylic acid

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.9 Other treatment: ciclopirox olamine shampoo

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.10 Other treatment: fluocinolone acetonide, plus occlusion

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.11 Other treatment: salicylic acid

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4 PAGI Show forest plot

5

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

4.1 Vitamin D: calcipotriol

2

450

Std. Mean Difference (IV, Random, 95% CI)

‐0.66 [‐1.28, ‐0.05]

4.2 Potent steroid: betamethasone dipropionate

1

685

Std. Mean Difference (IV, Random, 95% CI)

‐1.23 [‐1.43, ‐1.03]

4.3 Potent steroid: betamethasone valerate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.4 Very potent steroid: amcinonide

1

132

Std. Mean Difference (IV, Random, 95% CI)

‐0.97 [‐1.33, ‐0.61]

4.5 Very potent steroid: clobetasol propionate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.6 Very potent steroid: halcinonide

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.7 Vitamin D in combination: calcipotriol + BMD

2

841

Std. Mean Difference (IV, Random, 95% CI)

‐1.00 [‐1.79, ‐0.22]

4.8 Other treatment: betamethasone‐17,21‐dipropionate plus salicylic acid

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.9 Other treatment: ciclopirox olamine shampoo

1

37

Std. Mean Difference (IV, Random, 95% CI)

‐0.11 [‐0.86, 0.64]

4.10 Other treatment: fluocinolone acetonide, plus occlusion

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.11 Other treatment: salicylic acid

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5 Combined end point (IAGI/TSS/PASI/PAGI) Show forest plot

13

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

5.1 Vitamin D: calcipotriol

2

457

Std. Mean Difference (IV, Random, 95% CI)

‐0.72 [‐1.28, ‐0.16]

5.2 Potent steroid: betamethasone dipropionate

2

712

Std. Mean Difference (IV, Random, 95% CI)

‐1.09 [‐1.29, ‐0.90]

5.3 Potent steroid: betamethasone valerate

1

172

Std. Mean Difference (IV, Random, 95% CI)

‐1.40 [‐1.75, ‐1.05]

5.4 Very potent steroid: amcinonide

1

132

Std. Mean Difference (IV, Random, 95% CI)

‐1.42 [‐1.80, ‐1.04]

5.5 Very potent steroid: clobetasol propionate

4

788

Std. Mean Difference (IV, Random, 95% CI)

‐1.57 [‐1.81, ‐1.34]

5.6 Very potent steroid: halcinonide

1

54

Std. Mean Difference (IV, Random, 95% CI)

‐1.11 [‐1.69, ‐0.53]

5.7 Vitamin D in combination: calcipotriol + BMD

2

854

Std. Mean Difference (IV, Random, 95% CI)

‐0.97 [‐1.61, ‐0.32]

5.8 Other treatment: betamethasone‐17,21‐dipropionate plus salicylic acid

1

20

Std. Mean Difference (IV, Random, 95% CI)

‐1.48 [‐2.50, ‐0.47]

5.9 Other treatment: ciclopirox olamine shampoo

1

37

Std. Mean Difference (IV, Random, 95% CI)

‐0.07 [‐0.82, 0.68]

5.10 Other treatment: fluocinolone acetonide, plus occlusion

1

84

Std. Mean Difference (IV, Random, 95% CI)

‐1.22 [‐1.69, ‐0.76]

5.11 Other treatment: salicylic acid

1

20

Std. Mean Difference (IV, Random, 95% CI)

‐0.86 [‐1.79, 0.06]

6 Total withdrawals Show forest plot

13

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

6.1 Vitamin D: calcipotriol

3

517

Risk Difference (M‐H, Random, 95% CI)

‐0.02 [‐0.08, 0.05]

6.2 Potent steroid: betamethasone dipropionate

1

692

Risk Difference (M‐H, Random, 95% CI)

‐0.14 [‐0.21, ‐0.06]

6.3 Potent steroid: betamethasone valerate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.4 Very potent steroid: amcinonide

1

165

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.11, 0.11]

6.5 Very potent steroid: clobetasol propionate

5

1006

Risk Difference (M‐H, Random, 95% CI)

‐0.03 [‐0.10, 0.04]

6.6 Very potent steroid: halcinonide

1

58

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.13, 0.13]

6.7 Vitamin D in combination: calcipotriol + BMD

2

854

Risk Difference (M‐H, Random, 95% CI)

‐0.09 [‐0.16, ‐0.03]

6.8 Other treatment: betamethasone‐17,21‐dipropionate plus salicylic acid

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.9 Other treatment: ciclopirox olamine shampoo

1

40

Risk Difference (M‐H, Random, 95% CI)

‐0.15 [‐0.38, 0.09]

6.10 Other treatment: fluocinolone acetonide, plus occlusion

1

89

Risk Difference (M‐H, Random, 95% CI)

‐0.04 [‐0.13, 0.04]

6.11 Other treatment: salicylic acid

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7 Withdrawals due to adverse events Show forest plot

13

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

7.1 Vitamin D: calcipotriol

3

517

Risk Difference (M‐H, Random, 95% CI)

0.02 [‐0.02, 0.05]

7.2 Potent steroid: betamethasone dipropionate

2

712

Risk Difference (M‐H, Random, 95% CI)

‐0.04 [‐0.08, ‐0.00]

7.3 Potent steroid: betamethasone valerate

1

172

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.03, 0.03]

7.4 Very potent steroid: amcinonide

1

165

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.02, 0.04]

7.5 Very potent steroid: clobetasol propionate

5

1006

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.02, 0.01]

7.6 Very potent steroid: halcinonide

1

58

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.06, 0.06]

7.7 Vitamin D in combination: calcipotriol + BMD

1

677

Risk Difference (M‐H, Random, 95% CI)

‐0.04 [‐0.08, 0.00]

7.8 Other treatment: betamethasone‐17,21‐dipropionate plus salicylic acid

1

20

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.17, 0.17]

7.9 Other treatment: ciclopirox olamine shampoo

1

40

Risk Difference (M‐H, Random, 95% CI)

‐0.18 [‐0.42, 0.05]

7.10 Other treatment: fluocinolone acetonide, plus occlusion

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.11 Other treatment: salicylic acid

1

20

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.17, 0.17]

8 Withdrawals due to treatment failure Show forest plot

9

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

8.1 Vitamin D: calcipotriol

2

457

Risk Difference (M‐H, Random, 95% CI)

‐0.05 [‐0.11, 0.00]

8.2 Potent steroid: betamethasone dipropionate

1

692

Risk Difference (M‐H, Random, 95% CI)

‐0.10 [‐0.16, ‐0.05]

8.3 Potent steroid: betamethasone valerate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.4 Very potent steroid: amcinonide

1

165

Risk Difference (M‐H, Random, 95% CI)

‐0.01 [‐0.05, 0.02]

8.5 Very potent steroid: clobetasol propionate

5

1006

Risk Difference (M‐H, Random, 95% CI)

‐0.01 [‐0.05, 0.02]

8.6 Very potent steroid: halcinonide

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.7 Vitamin D in combination: calcipotriol + BMD

1

677

Risk Difference (M‐H, Random, 95% CI)

‐0.11 [‐0.17, ‐0.06]

8.8 Other treatment: betamethasone‐17,21‐dipropionate plus salicylic acid

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.9 Other treatment: ciclopirox olamine shampoo

1

40

Risk Difference (M‐H, Random, 95% CI)

‐0.09 [‐0.28, 0.10]

8.10 Other treatment: fluocinolone acetonide, plus occlusion

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.11 Other treatment: salicylic acid

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9 Adverse events (local) Show forest plot

12

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

9.1 Vitamin D: calcipotriol

3

510

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.05, 0.04]

9.2 Potent steroid: betamethasone dipropionate

2

703

Risk Difference (M‐H, Random, 95% CI)

‐0.07 [‐0.13, ‐0.01]

9.3 Potent steroid: betamethasone valerate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.4 Very potent steroid: amcinonide

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.5 Very potent steroid: clobetasol propionate

4

817

Risk Difference (M‐H, Random, 95% CI)

0.00 [‐0.03, 0.04]

9.6 Very potent steroid: halcinonide

1

58

Risk Difference (M‐H, Random, 95% CI)

‐0.03 [‐0.12, 0.06]

9.7 Vitamin D in combination: calcipotriol + BMD

2

831

Risk Difference (M‐H, Random, 95% CI)

‐0.06 [‐0.13, 0.02]

9.8 Other treatment: betamethasone‐17,21‐dipropionate plus salicylic acid

1

20

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.17, 0.17]

9.9 Other treatment: ciclopirox olamine shampoo

1

40

Risk Difference (M‐H, Random, 95% CI)

‐0.06 [‐0.24, 0.13]

9.10 Other treatment: fluocinolone acetonide, plus occlusion

1

89

Risk Difference (M‐H, Random, 95% CI)

0.02 [‐0.04, 0.08]

9.11 Other treatment: salicylic acid

1

20

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.17, 0.17]

10 Adverse events (systemic) Show forest plot

4

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

10.1 Vitamin D: calcipotriol

1

408

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.01, 0.01]

10.2 Potent steroid: betamethasone dipropionate

1

692

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.01, 0.01]

10.3 Potent steroid: betamethasone valerate

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.4 Very potent steroid: amcinonide

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.5 Very potent steroid: clobetasol propionate

2

385

Risk Difference (M‐H, Random, 95% CI)

‐0.01 [‐0.03, 0.02]

10.6 Very potent steroid: halcinonide

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.7 Vitamin D in combination: calcipotriol + BMD

2

843

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.01, 0.01]

10.8 Other treatment: betamethasone‐17,21‐dipropionate plus salicylic acid

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.9 Other treatment: ciclopirox olamine shampoo

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.10 Other treatment: fluocinolone acetonide, plus occlusion

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.11 Other treatment: salicylic acid

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 18. Scalp psoriasis: placebo‐controlled trials
Comparison 19. Scalp psoriasis: vitamin D alone or in combination versus other treatments

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 IAGI Show forest plot

9

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 Vitamin D vs. corticosteroid (potent): calcipotriol vs. BMD

2

1676

Std. Mean Difference (IV, Random, 95% CI)

0.48 [0.32, 0.64]

1.2 Vitamin D vs. corticosteroid (potent): calcipotriol vs. BMV

2

510

Std. Mean Difference (IV, Random, 95% CI)

0.37 [0.20, 0.55]

1.3 Vitamin D vs. corticosteroid (very potent): calcipotriol vs. clobetasol propionate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.4 Vitamin D + corticosteroid vs. corticosteroid: calcipotriol + BMD vs. BMD

3

2444

Std. Mean Difference (IV, Random, 95% CI)

‐0.18 [‐0.26, ‐0.10]

1.5 Vitamin D vs. vitamin D + corticosteroid: calcipotriol vs. calcipotriol + BMD

4

2581

Std. Mean Difference (IV, Random, 95% CI)

0.64 [0.44, 0.84]

1.6 Vitamin D vs. other treatments: calcipotriol vs. coal tar polytherapy

2

748

Std. Mean Difference (IV, Random, 95% CI)

‐0.24 [‐0.73, 0.25]

2 TSS Show forest plot

10

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

2.1 Vitamin D vs. corticosteroid (potent): calcipotriol vs. BMD

2

1676

Std. Mean Difference (IV, Random, 95% CI)

0.45 [0.28, 0.63]

2.2 Vitamin D vs. corticosteroid (potent): calcipotriol vs. BMV

2

487

Std. Mean Difference (IV, Random, 95% CI)

0.09 [‐0.09, 0.27]

2.3 Vitamin D vs. corticosteroid (very potent): calcipotriol vs. clobetasol propionate

1

151

Std. Mean Difference (IV, Random, 95% CI)

0.37 [0.05, 0.69]

2.4 Vitamin D + corticosteroid vs. corticosteroid: calcipotriol + BMD vs. BMD

3

2444

Std. Mean Difference (IV, Random, 95% CI)

‐0.19 [‐0.27, ‐0.11]

2.5 Vitamin D vs. vitamin D + corticosteroid: calcipotriol vs. calcipotriol + BMD

3

1978

Std. Mean Difference (IV, Random, 95% CI)

0.70 [0.56, 0.84]

2.6 Vitamin D vs. other treatments: calcipotriol vs. coal tar polytherapy

3

925

Std. Mean Difference (IV, Random, 95% CI)

‐0.30 [‐0.84, 0.24]

3 PASI

0

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

3.1 Vitamin D vs. corticosteroid (potent): calcipotriol vs. BMD

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.2 Vitamin D vs. corticosteroid (potent): calcipotriol vs. BMV

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.3 Vitamin D vs. corticosteroid (very potent): calcipotriol vs. clobetasol propionate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.4 Vitamin D + corticosteroid vs. corticosteroid: calcipotriol + BMD vs. BMD

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.5 Vitamin D vs. vitamin D + corticosteroid: calcipotriol vs. calcipotriol + BMD

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.6 Vitamin D vs. other treatments: calcipotriol vs. coal tar polytherapy

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4 PAGI Show forest plot

5

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

4.1 Vitamin D vs. corticosteroid (potent): calcipotriol vs. BMD

2

1654

Std. Mean Difference (IV, Random, 95% CI)

0.56 [0.31, 0.81]

4.2 Vitamin D vs. corticosteroid (potent): calcipotriol vs. BMV

1

468

Std. Mean Difference (IV, Random, 95% CI)

0.41 [0.22, 0.59]

4.3 Vitamin D vs. corticosteroid (very potent): calcipotriol vs. clobetasol propionate

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.4 Vitamin D + corticosteroid vs. corticosteroid: calcipotriol + BMD vs. BMD

3

2414

Std. Mean Difference (IV, Random, 95% CI)

‐0.17 [‐0.25, ‐0.09]

4.5 Vitamin D vs. vitamin D + corticosteroid: calcipotriol vs. calcipotriol + BMD

3

1952

Std. Mean Difference (IV, Random, 95% CI)

0.84 [0.61, 1.08]

4.6 Vitamin D vs. other treatments: calcipotriol vs. coal tar polytherapy

0

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5 Combined end point (IAGI/TSS/PASI/PAGI) Show forest plot

11

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

5.1 Vitamin D vs. corticosteroid (potent): calcipotriol vs. BMD

2

1676

Std. Mean Difference (IV, Random, 95% CI)

0.48 [0.32, 0.64]

5.2 Vitamin D vs. corticosteroid (potent): calcipotriol vs. BMV

2

510

Std. Mean Difference (IV, Random, 95% CI)

0.37 [0.20, 0.55]

5.3 Vitamin D vs. corticosteroid (very potent): calcipotriol vs. clobetasol propionate

1

151

Std. Mean Difference (IV, Random, 95% CI)

0.37 [0.05, 0.69]

5.4 Vitamin D + corticosteroid vs. corticosteroid: calcipotriol + BMD vs. BMD

3

2444

Std. Mean Difference (IV, Random, 95% CI)

‐0.18 [‐0.26, ‐0.10]

5.5 Vitamin D vs. vitamin D + corticosteroid: calcipotriol vs. calcipotriol + BMD

4

2581

Std. Mean Difference (IV, Random, 95% CI)

0.64 [0.44, 0.84]

5.6 Vitamin D vs. other treatments: calcipotriol vs. coal tar polytherapy

3

835

Std. Mean Difference (IV, Random, 95% CI)

‐0.45 [‐0.92, 0.02]

6 Total withdrawals Show forest plot

10

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

6.1 Vitamin D vs. corticosteroid (potent): calcipotriol vs. BMD

2

1676

Risk Difference (M‐H, Random, 95% CI)

0.07 [‐0.04, 0.18]

6.2 Vitamin D vs. corticosteroid (potent): calcipotriol vs. BMV

2

516

Risk Difference (M‐H, Random, 95% CI)

0.04 [‐0.00, 0.08]

6.3 Vitamin D vs. corticosteroid (very potent): calcipotriol vs. clobetasol propionate

2

194

Risk Difference (M‐H, Random, 95% CI)

0.05 [‐0.07, 0.18]

6.4 Vitamin D + corticosteroid vs. corticosteroid: calcipotriol + BMD vs. BMD

3

2444

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.04, 0.06]

6.5 Vitamin D vs. vitamin D + corticosteroid: calcipotriol vs. calcipotriol + BMD

4

2847

Risk Difference (M‐H, Random, 95% CI)

0.11 [0.05, 0.18]

6.6 Vitamin D vs. other treatments: calcipotriol vs. coal tar polytherapy

1

475

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.07, 0.09]

7 Withdrawals due to adverse events Show forest plot

10

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

7.1 Vitamin D vs. corticosteroid (potent): calcipotriol vs. BMD

2

1676

Risk Difference (M‐H, Random, 95% CI)

0.04 [‐0.01, 0.09]

7.2 Vitamin D vs. corticosteroid (potent): calcipotriol vs. BMV

2

516

Risk Difference (M‐H, Random, 95% CI)

0.03 [0.01, 0.06]

7.3 Vitamin D vs. corticosteroid (very potent): calcipotriol vs. clobetasol propionate

2

194

Risk Difference (M‐H, Random, 95% CI)

0.05 [‐0.05, 0.15]

7.4 Vitamin D + corticosteroid vs. corticosteroid: calcipotriol + BMD vs. BMD

3

2444

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.01, 0.01]

7.5 Vitamin D vs. vitamin D + corticosteroid: calcipotriol vs. calcipotriol + BMD

4

2847

Risk Difference (M‐H, Random, 95% CI)

0.06 [0.02, 0.09]

7.6 Vitamin D vs. other treatments: calcipotriol vs. coal tar polytherapy

1

445

Risk Difference (M‐H, Random, 95% CI)

0.08 [0.02, 0.14]

8 Withdrawals due to treatment failure Show forest plot

8

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

8.1 Vitamin D vs. corticosteroid (potent): calcipotriol vs. BMD

2

1676

Risk Difference (M‐H, Random, 95% CI)

0.03 [‐0.01, 0.07]

8.2 Vitamin D vs. corticosteroid (potent): calcipotriol vs. BMV

2

516

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.01, 0.03]

8.3 Vitamin D vs. corticosteroid (very potent): calcipotriol vs. clobetasol propionate

2

194

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.02, 0.04]

8.4 Vitamin D + corticosteroid vs. corticosteroid: calcipotriol + BMD vs. BMD

3

2444

Risk Difference (M‐H, Random, 95% CI)

‐0.01 [‐0.02, ‐0.00]

8.5 Vitamin D vs. vitamin D + corticosteroid: calcipotriol vs. calcipotriol + BMD

3

2535

Risk Difference (M‐H, Random, 95% CI)

0.05 [0.01, 0.10]

8.6 Vitamin D vs. other treatments: calcipotriol vs. coal tar polytherapy

0

0

Risk Difference (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9 Adverse events (local) Show forest plot

10

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

9.1 Vitamin D vs. corticosteroid (potent): calcipotriol vs. BMD

2

1652

Risk Difference (M‐H, Random, 95% CI)

0.07 [0.04, 0.11]

9.2 Vitamin D vs. corticosteroid (potent): calcipotriol vs. BMV

2

516

Risk Difference (M‐H, Random, 95% CI)

0.17 [0.01, 0.33]

9.3 Vitamin D vs. corticosteroid (very potent): calcipotriol vs. clobetasol propionate

2

194

Risk Difference (M‐H, Random, 95% CI)

0.19 [0.10, 0.28]

9.4 Vitamin D + corticosteroid vs. corticosteroid: calcipotriol + BMD vs. BMD

3

2415

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.02, 0.01]

9.5 Vitamin D vs. vitamin D + corticosteroid: calcipotriol vs. calcipotriol + BMD

4

2801

Risk Difference (M‐H, Random, 95% CI)

0.09 [0.06, 0.12]

9.6 Vitamin D vs. other treatments: calcipotriol vs. coal tar polytherapy

1

445

Risk Difference (M‐H, Random, 95% CI)

0.24 [0.15, 0.33]

10 Adverse events (systemic) Show forest plot

6

Risk Difference (M‐H, Random, 95% CI)

Subtotals only

10.1 Vitamin D vs. corticosteroid (potent): calcipotriol vs. BMD

2

1666

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.00, 0.00]

10.2 Vitamin D vs. corticosteroid (potent): calcipotriol vs. BMV

1

474

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.01, 0.01]

10.3 Vitamin D vs. corticosteroid (very potent): calcipotriol vs. clobetasol propionate

1

151

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.03, 0.03]

10.4 Vitamin D + corticosteroid vs. corticosteroid: calcipotriol + BMD vs. BMD

2

2216

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.00, 0.00]

10.5 Vitamin D vs. vitamin D + corticosteroid: calcipotriol vs. calcipotriol + BMD

3

1970

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.00, 0.00]

10.6 Vitamin D vs. other treatments: calcipotriol vs. coal tar polytherapy

1

445

Risk Difference (M‐H, Random, 95% CI)

0.0 [‐0.01, 0.01]

Figures and Tables -
Comparison 19. Scalp psoriasis: vitamin D alone or in combination versus other treatments