Scolaris Content Display Scolaris Content Display

Study flow diagram.
Figuras y tablas -
Figure 1

Study flow diagram.

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Figuras y tablas -
Figure 2

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

Funnel plot of comparison: 15 Imiquimod versus placebo: different concentrations, outcome: 15.1 Participant complete clearance.
Figuras y tablas -
Figure 3

Funnel plot of comparison: 15 Imiquimod versus placebo: different concentrations, outcome: 15.1 Participant complete clearance.

Funnel plot of comparison: 50 MAL‐PDT (red light) versus placebo‐PDT (red light), outcome: 50.1 Participant complete clearance.
Figuras y tablas -
Figure 4

Funnel plot of comparison: 50 MAL‐PDT (red light) versus placebo‐PDT (red light), outcome: 50.1 Participant complete clearance.

Comparison 1 Adapalene gel versus placebo, Outcome 1 Global Improvement Indices (investigator)‐cleared.
Figuras y tablas -
Analysis 1.1

Comparison 1 Adapalene gel versus placebo, Outcome 1 Global Improvement Indices (investigator)‐cleared.

Comparison 1 Adapalene gel versus placebo, Outcome 2 Mean changes in lesion counts.
Figuras y tablas -
Analysis 1.2

Comparison 1 Adapalene gel versus placebo, Outcome 2 Mean changes in lesion counts.

Comparison 1 Adapalene gel versus placebo, Outcome 3 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 1.3

Comparison 1 Adapalene gel versus placebo, Outcome 3 Withdrawal due to adverse events.

Comparison 1 Adapalene gel versus placebo, Outcome 4 Minor adverse events excluding skin irritation: dermatitis.
Figuras y tablas -
Analysis 1.4

Comparison 1 Adapalene gel versus placebo, Outcome 4 Minor adverse events excluding skin irritation: dermatitis.

Comparison 2 0.1% adapalene vs 0.3% adapalene, Outcome 1 Global Improvement Indices (investigator)‐cleared.
Figuras y tablas -
Analysis 2.1

Comparison 2 0.1% adapalene vs 0.3% adapalene, Outcome 1 Global Improvement Indices (investigator)‐cleared.

Comparison 2 0.1% adapalene vs 0.3% adapalene, Outcome 2 Mean changes in lesion counts.
Figuras y tablas -
Analysis 2.2

Comparison 2 0.1% adapalene vs 0.3% adapalene, Outcome 2 Mean changes in lesion counts.

Comparison 2 0.1% adapalene vs 0.3% adapalene, Outcome 3 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 2.3

Comparison 2 0.1% adapalene vs 0.3% adapalene, Outcome 3 Withdrawal due to adverse events.

Comparison 2 0.1% adapalene vs 0.3% adapalene, Outcome 4 Minor adverse events excluding skin irritation: dermatitis.
Figuras y tablas -
Analysis 2.4

Comparison 2 0.1% adapalene vs 0.3% adapalene, Outcome 4 Minor adverse events excluding skin irritation: dermatitis.

Comparison 3 Arotinoid Methyl Sulfone (Ro 14‐9706) versus Tretinoin, Outcome 1 Mean percentage of reduction in lesion counts.
Figuras y tablas -
Analysis 3.1

Comparison 3 Arotinoid Methyl Sulfone (Ro 14‐9706) versus Tretinoin, Outcome 1 Mean percentage of reduction in lesion counts.

Comparison 4 Calcipotriol (vitamin D) versus placebo, Outcome 1 Mean changes in lesion counts.
Figuras y tablas -
Analysis 4.1

Comparison 4 Calcipotriol (vitamin D) versus placebo, Outcome 1 Mean changes in lesion counts.

Comparison 4 Calcipotriol (vitamin D) versus placebo, Outcome 2 Cosmetic outcomes: Reduction in total cosmetic appearance score.
Figuras y tablas -
Analysis 4.2

Comparison 4 Calcipotriol (vitamin D) versus placebo, Outcome 2 Cosmetic outcomes: Reduction in total cosmetic appearance score.

Comparison 5 1% colchicine cream versus 0.5% colchicine cream, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 5.1

Comparison 5 1% colchicine cream versus 0.5% colchicine cream, Outcome 1 Participant complete clearance.

Comparison 5 1% colchicine cream versus 0.5% colchicine cream, Outcome 2 Mean reduction in lesion counts‐total.
Figuras y tablas -
Analysis 5.2

Comparison 5 1% colchicine cream versus 0.5% colchicine cream, Outcome 2 Mean reduction in lesion counts‐total.

Comparison 5 1% colchicine cream versus 0.5% colchicine cream, Outcome 3 Mean reduction in lesion counts‐per anatomical locations.
Figuras y tablas -
Analysis 5.3

Comparison 5 1% colchicine cream versus 0.5% colchicine cream, Outcome 3 Mean reduction in lesion counts‐per anatomical locations.

Comparison 5 1% colchicine cream versus 0.5% colchicine cream, Outcome 4 Cosmetic outcomes: Number of participants with decreased infiltration and disappearance of crust.
Figuras y tablas -
Analysis 5.4

Comparison 5 1% colchicine cream versus 0.5% colchicine cream, Outcome 4 Cosmetic outcomes: Number of participants with decreased infiltration and disappearance of crust.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 1 Investigator Global Improvement Indices‐completely improved.
Figuras y tablas -
Analysis 6.1

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 1 Investigator Global Improvement Indices‐completely improved.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 2 Participant Global Improvement Indices‐completely improved.
Figuras y tablas -
Analysis 6.2

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 2 Participant Global Improvement Indices‐completely improved.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 3 Participant complete clearance at end of treatment (>56 days).
Figuras y tablas -
Analysis 6.3

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 3 Participant complete clearance at end of treatment (>56 days).

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 4 Participant complete clearance (target lesions).
Figuras y tablas -
Analysis 6.4

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 4 Participant complete clearance (target lesions).

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 5 Participant complete clearance (all lesions).
Figuras y tablas -
Analysis 6.5

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 5 Participant complete clearance (all lesions).

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 6 Participant complete clearance for 30 day treatment by locations.
Figuras y tablas -
Analysis 6.6

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 6 Participant complete clearance for 30 day treatment by locations.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 7 Participant complete clearance for 60 day treatment by locations.
Figuras y tablas -
Analysis 6.7

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 7 Participant complete clearance for 60 day treatment by locations.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 8 Participant complete clearance for 90 day treatment by locations.
Figuras y tablas -
Analysis 6.8

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 8 Participant complete clearance for 90 day treatment by locations.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 9 Participant complete clearance in immunosuppressed participants.
Figuras y tablas -
Analysis 6.9

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 9 Participant complete clearance in immunosuppressed participants.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 10 Participant partial (>75%) clearance in immunosuppressed participants.
Figuras y tablas -
Analysis 6.10

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 10 Participant partial (>75%) clearance in immunosuppressed participants.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 11 Mean reduction of lesion counts (30‐90 days ): At the end of study.
Figuras y tablas -
Analysis 6.11

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 11 Mean reduction of lesion counts (30‐90 days ): At the end of study.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 12 Mean reduction of lesion counts (30‐90 days): 30 day follow‐up.
Figuras y tablas -
Analysis 6.12

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 12 Mean reduction of lesion counts (30‐90 days): 30 day follow‐up.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 13 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 6.13

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 13 Withdrawal due to adverse events.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 14 Minor adverse event: body as a whole : in general.
Figuras y tablas -
Analysis 6.14

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 14 Minor adverse event: body as a whole : in general.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 15 Minor adverse event: body as a whole : "flu".
Figuras y tablas -
Analysis 6.15

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 15 Minor adverse event: body as a whole : "flu".

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 16 Minor adverse event:: body as a whole : infection.
Figuras y tablas -
Analysis 6.16

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 16 Minor adverse event:: body as a whole : infection.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 17 Minor adverse event: cardiovascular: in general.
Figuras y tablas -
Analysis 6.17

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 17 Minor adverse event: cardiovascular: in general.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 18 Minor adverse event: cardiovascular: sinus bradycardia.
Figuras y tablas -
Analysis 6.18

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 18 Minor adverse event: cardiovascular: sinus bradycardia.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 19 Minor adverse event: dermatological: bursitis.
Figuras y tablas -
Analysis 6.19

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 19 Minor adverse event: dermatological: bursitis.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 20 Minor adverse event: dermatological: dry skin.
Figuras y tablas -
Analysis 6.20

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 20 Minor adverse event: dermatological: dry skin.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 21 Minor adverse event: dermatological: herpes zoster.
Figuras y tablas -
Analysis 6.21

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 21 Minor adverse event: dermatological: herpes zoster.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 22 Minor adverse event: dermatological: rash vesiculobullous.
Figuras y tablas -
Analysis 6.22

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 22 Minor adverse event: dermatological: rash vesiculobullous.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 23 Minor adverse event::dermatological: seborrhoea.
Figuras y tablas -
Analysis 6.23

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 23 Minor adverse event::dermatological: seborrhoea.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 24 Minor adverse event: dermatological: skin exfoliation.
Figuras y tablas -
Analysis 6.24

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 24 Minor adverse event: dermatological: skin exfoliation.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 25 Minor adverse event: dermatological: ulcerated skin.
Figuras y tablas -
Analysis 6.25

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 25 Minor adverse event: dermatological: ulcerated skin.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 26 Minor adverse event: digestive : in general.
Figuras y tablas -
Analysis 6.26

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 26 Minor adverse event: digestive : in general.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 27 Minor adverse event: hemic and lymphatic: in general.
Figuras y tablas -
Analysis 6.27

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 27 Minor adverse event: hemic and lymphatic: in general.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 28 Minor adverse event: metabolic and nutritional disorders : in general.
Figuras y tablas -
Analysis 6.28

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 28 Minor adverse event: metabolic and nutritional disorders : in general.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 29 Minor adverse event: musculoskeletal and connective tissue: in general.
Figuras y tablas -
Analysis 6.29

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 29 Minor adverse event: musculoskeletal and connective tissue: in general.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 30 Minor adverse event: musculoskeletal and connective tissue: hypokinesia.
Figuras y tablas -
Analysis 6.30

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 30 Minor adverse event: musculoskeletal and connective tissue: hypokinesia.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 31 Minor adverse event: nervous system: in general.
Figuras y tablas -
Analysis 6.31

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 31 Minor adverse event: nervous system: in general.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 32 Minor adverse event: nervous system: headache.
Figuras y tablas -
Analysis 6.32

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 32 Minor adverse event: nervous system: headache.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 33 Minor adverse event: nervous system: hyperaesthesia.
Figuras y tablas -
Analysis 6.33

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 33 Minor adverse event: nervous system: hyperaesthesia.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 34 Minor adverse event: nervous system: paraesthesia.
Figuras y tablas -
Analysis 6.34

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 34 Minor adverse event: nervous system: paraesthesia.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 35 Minor adverse event: respiratory: in general.
Figuras y tablas -
Analysis 6.35

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 35 Minor adverse event: respiratory: in general.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 36 Minor adverse event: respiratory: bronchitis.
Figuras y tablas -
Analysis 6.36

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 36 Minor adverse event: respiratory: bronchitis.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 37 Minor adverse event: respiratory: pharyngitis.
Figuras y tablas -
Analysis 6.37

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 37 Minor adverse event: respiratory: pharyngitis.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 38 Minor adverse event: respiratory: upper respiratory tract infection.
Figuras y tablas -
Analysis 6.38

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 38 Minor adverse event: respiratory: upper respiratory tract infection.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 39 Minor adverse event: special senses: in general.
Figuras y tablas -
Analysis 6.39

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 39 Minor adverse event: special senses: in general.

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 40 Minor adverse event: urogenital: in general.
Figuras y tablas -
Analysis 6.40

Comparison 6 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle), Outcome 40 Minor adverse event: urogenital: in general.

Comparison 7 3% diclofenac in 2.5% hyaluronic acid versus 5% imiquimod, Outcome 1 Investigator Global Improvement Indices‐Complete improvement.
Figuras y tablas -
Analysis 7.1

Comparison 7 3% diclofenac in 2.5% hyaluronic acid versus 5% imiquimod, Outcome 1 Investigator Global Improvement Indices‐Complete improvement.

Comparison 7 3% diclofenac in 2.5% hyaluronic acid versus 5% imiquimod, Outcome 2 Participant Global Improvement Indices‐Complete improvement.
Figuras y tablas -
Analysis 7.2

Comparison 7 3% diclofenac in 2.5% hyaluronic acid versus 5% imiquimod, Outcome 2 Participant Global Improvement Indices‐Complete improvement.

Comparison 8 2‐(Difluoromethyl)‐dl‐ornithine (DFMO) versus placebo, Outcome 1 Mean reduction in lesions counts.
Figuras y tablas -
Analysis 8.1

Comparison 8 2‐(Difluoromethyl)‐dl‐ornithine (DFMO) versus placebo, Outcome 1 Mean reduction in lesions counts.

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 9.1

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 1 Participant complete clearance.

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 2 Mean reduction in lesion counts.
Figuras y tablas -
Analysis 9.2

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 2 Mean reduction in lesion counts.

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 3 Mean percentage of reduction in lesion counts.
Figuras y tablas -
Analysis 9.3

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 3 Mean percentage of reduction in lesion counts.

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 4 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 9.4

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 4 Withdrawal due to adverse events.

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 5 Skin irritation.
Figuras y tablas -
Analysis 9.5

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 5 Skin irritation.

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 6 Minor adverse event excluding skin irritation: body as a whole : in general.
Figuras y tablas -
Analysis 9.6

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 6 Minor adverse event excluding skin irritation: body as a whole : in general.

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 7 Minor adverse event excluding skin irritation: body as a whole : allergy.
Figuras y tablas -
Analysis 9.7

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 7 Minor adverse event excluding skin irritation: body as a whole : allergy.

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 8 Minor adverse event excluding skin irritation: body as a whole : "flu" or common cold.
Figuras y tablas -
Analysis 9.8

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 8 Minor adverse event excluding skin irritation: body as a whole : "flu" or common cold.

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 9 Minor adverse event excluding skin irritation: musculoskeletal and connective tissue: in general.
Figuras y tablas -
Analysis 9.9

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 9 Minor adverse event excluding skin irritation: musculoskeletal and connective tissue: in general.

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 10 Minor adverse event excluding skin irritation: musculoskeletal and connective tissue: soreness.
Figuras y tablas -
Analysis 9.10

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 10 Minor adverse event excluding skin irritation: musculoskeletal and connective tissue: soreness.

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 11 Minor adverse event excluding skin irritation:nervous system: headache.
Figuras y tablas -
Analysis 9.11

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 11 Minor adverse event excluding skin irritation:nervous system: headache.

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 12 Minor adverse event excluding skin irritation: respiratory: in general.
Figuras y tablas -
Analysis 9.12

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 12 Minor adverse event excluding skin irritation: respiratory: in general.

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 13 Minor adverse event excluding skin irritation: respiratory: sinusitis.
Figuras y tablas -
Analysis 9.13

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 13 Minor adverse event excluding skin irritation: respiratory: sinusitis.

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 14 Minor adverse event excluding skin irritation: respiratory: upper respiratory tract infection.
Figuras y tablas -
Analysis 9.14

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 14 Minor adverse event excluding skin irritation: respiratory: upper respiratory tract infection.

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 15 Minor adverse event excluding skin irritation: special senses: in general.
Figuras y tablas -
Analysis 9.15

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 15 Minor adverse event excluding skin irritation: special senses: in general.

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 16 Minor adverse event excluding skin irritation:special senses: eye irritation.
Figuras y tablas -
Analysis 9.16

Comparison 9 0.5% 5‐FU versus vehicle, Outcome 16 Minor adverse event excluding skin irritation:special senses: eye irritation.

Comparison 10 0.5% 5‐FU at varying application durations, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 10.1

Comparison 10 0.5% 5‐FU at varying application durations, Outcome 1 Participant complete clearance.

Comparison 10 0.5% 5‐FU at varying application durations, Outcome 2 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 10.2

Comparison 10 0.5% 5‐FU at varying application durations, Outcome 2 Withdrawal due to adverse events.

Comparison 10 0.5% 5‐FU at varying application durations, Outcome 3 Skin irritation.
Figuras y tablas -
Analysis 10.3

Comparison 10 0.5% 5‐FU at varying application durations, Outcome 3 Skin irritation.

Comparison 10 0.5% 5‐FU at varying application durations, Outcome 4 Minor adverse events excluding skin irritation: body as a whole : in general.
Figuras y tablas -
Analysis 10.4

Comparison 10 0.5% 5‐FU at varying application durations, Outcome 4 Minor adverse events excluding skin irritation: body as a whole : in general.

Comparison 10 0.5% 5‐FU at varying application durations, Outcome 5 Minor adverse events excluding skin irritation: body as a whole : allergy.
Figuras y tablas -
Analysis 10.5

Comparison 10 0.5% 5‐FU at varying application durations, Outcome 5 Minor adverse events excluding skin irritation: body as a whole : allergy.

Comparison 10 0.5% 5‐FU at varying application durations, Outcome 6 Minor adverse events excluding skin irritation: body as a whole : "flu" or common cold.
Figuras y tablas -
Analysis 10.6

Comparison 10 0.5% 5‐FU at varying application durations, Outcome 6 Minor adverse events excluding skin irritation: body as a whole : "flu" or common cold.

Comparison 10 0.5% 5‐FU at varying application durations, Outcome 7 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: in general.
Figuras y tablas -
Analysis 10.7

Comparison 10 0.5% 5‐FU at varying application durations, Outcome 7 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: in general.

Comparison 10 0.5% 5‐FU at varying application durations, Outcome 8 Minor adverse events excluding skin irritation: nervous system: headache.
Figuras y tablas -
Analysis 10.8

Comparison 10 0.5% 5‐FU at varying application durations, Outcome 8 Minor adverse events excluding skin irritation: nervous system: headache.

Comparison 10 0.5% 5‐FU at varying application durations, Outcome 9 Minor adverse events excluding skin irritation: respiratory: in general.
Figuras y tablas -
Analysis 10.9

Comparison 10 0.5% 5‐FU at varying application durations, Outcome 9 Minor adverse events excluding skin irritation: respiratory: in general.

Comparison 10 0.5% 5‐FU at varying application durations, Outcome 10 Minor adverse events excluding skin irritation: respiratory: sinusitis.
Figuras y tablas -
Analysis 10.10

Comparison 10 0.5% 5‐FU at varying application durations, Outcome 10 Minor adverse events excluding skin irritation: respiratory: sinusitis.

Comparison 10 0.5% 5‐FU at varying application durations, Outcome 11 Minor adverse events excluding skin irritation: special senses: in general.
Figuras y tablas -
Analysis 10.11

Comparison 10 0.5% 5‐FU at varying application durations, Outcome 11 Minor adverse events excluding skin irritation: special senses: in general.

Comparison 10 0.5% 5‐FU at varying application durations, Outcome 12 Minor adverse events excluding skin irritation: special senses: eye irritation.
Figuras y tablas -
Analysis 10.12

Comparison 10 0.5% 5‐FU at varying application durations, Outcome 12 Minor adverse events excluding skin irritation: special senses: eye irritation.

Comparison 11 0.5% 5‐FU versus ALA‐PDT, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 11.1

Comparison 11 0.5% 5‐FU versus ALA‐PDT, Outcome 1 Participant complete clearance.

Comparison 11 0.5% 5‐FU versus ALA‐PDT, Outcome 2 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 11.2

Comparison 11 0.5% 5‐FU versus ALA‐PDT, Outcome 2 Withdrawal due to adverse events.

Comparison 12 5% 5‐FU with 0.05% tretinoin versus 5% 5‐FU with placebo, Outcome 1 Mean reduction in lesion counts.
Figuras y tablas -
Analysis 12.1

Comparison 12 5% 5‐FU with 0.05% tretinoin versus 5% 5‐FU with placebo, Outcome 1 Mean reduction in lesion counts.

Comparison 13 5% 5‐FU versus 5% imiquimod, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 13.1

Comparison 13 5% 5‐FU versus 5% imiquimod, Outcome 1 Participant complete clearance.

Comparison 14 5% 5‐FU versus cryotherapy, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 14.1

Comparison 14 5% 5‐FU versus cryotherapy, Outcome 1 Participant complete clearance.

Comparison 15 5% 5‐FU versus 10% masoprocol, Outcome 1 Investigator Global Improvement Indices ‐cleared.
Figuras y tablas -
Analysis 15.1

Comparison 15 5% 5‐FU versus 10% masoprocol, Outcome 1 Investigator Global Improvement Indices ‐cleared.

Comparison 15 5% 5‐FU versus 10% masoprocol, Outcome 2 Mean reduction of lesion counts.
Figuras y tablas -
Analysis 15.2

Comparison 15 5% 5‐FU versus 10% masoprocol, Outcome 2 Mean reduction of lesion counts.

Comparison 15 5% 5‐FU versus 10% masoprocol, Outcome 3 Mean percentage of reduction of lesion counts.
Figuras y tablas -
Analysis 15.3

Comparison 15 5% 5‐FU versus 10% masoprocol, Outcome 3 Mean percentage of reduction of lesion counts.

Comparison 15 5% 5‐FU versus 10% masoprocol, Outcome 4 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 15.4

Comparison 15 5% 5‐FU versus 10% masoprocol, Outcome 4 Withdrawal due to adverse events.

Comparison 16 5% 5‐FU versus carbon dioxide laser resurfacing, Outcome 1 Mean percentage of reduction of lesion counts.
Figuras y tablas -
Analysis 16.1

Comparison 16 5% 5‐FU versus carbon dioxide laser resurfacing, Outcome 1 Mean percentage of reduction of lesion counts.

Comparison 16 5% 5‐FU versus carbon dioxide laser resurfacing, Outcome 2 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 16.2

Comparison 16 5% 5‐FU versus carbon dioxide laser resurfacing, Outcome 2 Withdrawal due to adverse events.

Comparison 17 5% 5‐FU versus Er:YAG laser resurfacing, Outcome 1 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 17.1

Comparison 17 5% 5‐FU versus Er:YAG laser resurfacing, Outcome 1 Withdrawal due to adverse events.

Comparison 17 5% 5‐FU versus Er:YAG laser resurfacing, Outcome 2 Skin irritation.
Figuras y tablas -
Analysis 17.2

Comparison 17 5% 5‐FU versus Er:YAG laser resurfacing, Outcome 2 Skin irritation.

Comparison 18 5% 5‐FU versus Trichloroacetic acid peel, Outcome 1 Mean percentage of reduction in lesions.
Figuras y tablas -
Analysis 18.1

Comparison 18 5% 5‐FU versus Trichloroacetic acid peel, Outcome 1 Mean percentage of reduction in lesions.

Comparison 19 5% Imiquimod versus placebo, Outcome 1 Participant complete clearance‐number of doses.
Figuras y tablas -
Analysis 19.1

Comparison 19 5% Imiquimod versus placebo, Outcome 1 Participant complete clearance‐number of doses.

Comparison 19 5% Imiquimod versus placebo, Outcome 2 Participant complete clearance in immunosuppressed participants.
Figuras y tablas -
Analysis 19.2

Comparison 19 5% Imiquimod versus placebo, Outcome 2 Participant complete clearance in immunosuppressed participants.

Comparison 19 5% Imiquimod versus placebo, Outcome 3 Participant partial (>75%) clearance.
Figuras y tablas -
Analysis 19.3

Comparison 19 5% Imiquimod versus placebo, Outcome 3 Participant partial (>75%) clearance.

Comparison 19 5% Imiquimod versus placebo, Outcome 4 Participant partial (>75%) clearance in immunosuppressed participants.
Figuras y tablas -
Analysis 19.4

Comparison 19 5% Imiquimod versus placebo, Outcome 4 Participant partial (>75%) clearance in immunosuppressed participants.

Comparison 19 5% Imiquimod versus placebo, Outcome 5 Mean reduction in lesion counts.
Figuras y tablas -
Analysis 19.5

Comparison 19 5% Imiquimod versus placebo, Outcome 5 Mean reduction in lesion counts.

Comparison 19 5% Imiquimod versus placebo, Outcome 6 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 19.6

Comparison 19 5% Imiquimod versus placebo, Outcome 6 Withdrawal due to adverse events.

Comparison 19 5% Imiquimod versus placebo, Outcome 7 Withdrawal due to adverse events in immunosuppressed participants.
Figuras y tablas -
Analysis 19.7

Comparison 19 5% Imiquimod versus placebo, Outcome 7 Withdrawal due to adverse events in immunosuppressed participants.

Comparison 19 5% Imiquimod versus placebo, Outcome 8 Minor adverse events excluding skin irritation: body as a whole: in general.
Figuras y tablas -
Analysis 19.8

Comparison 19 5% Imiquimod versus placebo, Outcome 8 Minor adverse events excluding skin irritation: body as a whole: in general.

Comparison 19 5% Imiquimod versus placebo, Outcome 9 Minor adverse events excluding skin irritation: body as a whole: "flu" or "cold".
Figuras y tablas -
Analysis 19.9

Comparison 19 5% Imiquimod versus placebo, Outcome 9 Minor adverse events excluding skin irritation: body as a whole: "flu" or "cold".

Comparison 19 5% Imiquimod versus placebo, Outcome 10 Minor adverse events excluding skin irritation: digestive: in general.
Figuras y tablas -
Analysis 19.10

Comparison 19 5% Imiquimod versus placebo, Outcome 10 Minor adverse events excluding skin irritation: digestive: in general.

Comparison 19 5% Imiquimod versus placebo, Outcome 11 Minor adverse events excluding skin irritation: digestive: nausea.
Figuras y tablas -
Analysis 19.11

Comparison 19 5% Imiquimod versus placebo, Outcome 11 Minor adverse events excluding skin irritation: digestive: nausea.

Comparison 19 5% Imiquimod versus placebo, Outcome 12 Minor adverse events excluding skin irritation: nervous system: in general.
Figuras y tablas -
Analysis 19.12

Comparison 19 5% Imiquimod versus placebo, Outcome 12 Minor adverse events excluding skin irritation: nervous system: in general.

Comparison 19 5% Imiquimod versus placebo, Outcome 13 Cosmetic outcome: decrease in roughness/dryness/scaliness of the skin.
Figuras y tablas -
Analysis 19.13

Comparison 19 5% Imiquimod versus placebo, Outcome 13 Cosmetic outcome: decrease in roughness/dryness/scaliness of the skin.

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 20.1

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 1 Participant complete clearance.

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 2 Participant partial (>75%) clearance.
Figuras y tablas -
Analysis 20.2

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 2 Participant partial (>75%) clearance.

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 3 Mean percentage of reduction in lesion counts.
Figuras y tablas -
Analysis 20.3

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 3 Mean percentage of reduction in lesion counts.

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 4 Minor adverse events excluding skin irritation: body as a whole: 'flu" or "cold".
Figuras y tablas -
Analysis 20.4

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 4 Minor adverse events excluding skin irritation: body as a whole: 'flu" or "cold".

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 5 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 20.5

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 5 Withdrawal due to adverse events.

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 6 Skin irritation.
Figuras y tablas -
Analysis 20.6

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 6 Skin irritation.

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 7 Minor adverse events excluding skin irritation: body as a whole: pyrexia.
Figuras y tablas -
Analysis 20.7

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 7 Minor adverse events excluding skin irritation: body as a whole: pyrexia.

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 8 Minor adverse events excluding skin irritation: hemic and lymphatic: lymphadenopathy.
Figuras y tablas -
Analysis 20.8

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 8 Minor adverse events excluding skin irritation: hemic and lymphatic: lymphadenopathy.

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 9 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: myalgia.
Figuras y tablas -
Analysis 20.9

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 9 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: myalgia.

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 10 Minor adverse events excluding skin irritation: nervous system: fatigue.
Figuras y tablas -
Analysis 20.10

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 10 Minor adverse events excluding skin irritation: nervous system: fatigue.

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 11 Minor adverse events excluding skin irritation: nervous system: headache.
Figuras y tablas -
Analysis 20.11

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 11 Minor adverse events excluding skin irritation: nervous system: headache.

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 12 Minor adverse events excluding skin irritation: respiratory: cough.
Figuras y tablas -
Analysis 20.12

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 12 Minor adverse events excluding skin irritation: respiratory: cough.

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 13 Minor adverse events excluding skin irritation: respiratory: sinusitis.
Figuras y tablas -
Analysis 20.13

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 13 Minor adverse events excluding skin irritation: respiratory: sinusitis.

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 14 Minor adverse events excluding skin irritation: respiratory: upper respiratory tract infection.
Figuras y tablas -
Analysis 20.14

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 14 Minor adverse events excluding skin irritation: respiratory: upper respiratory tract infection.

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 15 Minor adverse events excluding skin irritation: urogenital: urinary tract infection.
Figuras y tablas -
Analysis 20.15

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 15 Minor adverse events excluding skin irritation: urogenital: urinary tract infection.

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 16 Cosmetic outcome: Participant's significantly or much improved cosmetic outcome assessed by investigator.
Figuras y tablas -
Analysis 20.16

Comparison 20 Imiquimod versus placebo: different concentrations, Outcome 16 Cosmetic outcome: Participant's significantly or much improved cosmetic outcome assessed by investigator.

Comparison 21 Imiquimod versus placebo: frequency of application, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 21.1

Comparison 21 Imiquimod versus placebo: frequency of application, Outcome 1 Participant complete clearance.

Comparison 21 Imiquimod versus placebo: frequency of application, Outcome 2 Participant partial (>75%) clearance.
Figuras y tablas -
Analysis 21.2

Comparison 21 Imiquimod versus placebo: frequency of application, Outcome 2 Participant partial (>75%) clearance.

Comparison 21 Imiquimod versus placebo: frequency of application, Outcome 3 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 21.3

Comparison 21 Imiquimod versus placebo: frequency of application, Outcome 3 Withdrawal due to adverse events.

Comparison 21 Imiquimod versus placebo: frequency of application, Outcome 4 Minor adverse events excluding skin irritation:body as a whole: in general.
Figuras y tablas -
Analysis 21.4

Comparison 21 Imiquimod versus placebo: frequency of application, Outcome 4 Minor adverse events excluding skin irritation:body as a whole: in general.

Comparison 21 Imiquimod versus placebo: frequency of application, Outcome 5 Minor adverse events excluding skin irritation: body as a whole:"flu" or "cold".
Figuras y tablas -
Analysis 21.5

Comparison 21 Imiquimod versus placebo: frequency of application, Outcome 5 Minor adverse events excluding skin irritation: body as a whole:"flu" or "cold".

Comparison 21 Imiquimod versus placebo: frequency of application, Outcome 6 Minor adverse events excluding skin irritation: digestive: in general.
Figuras y tablas -
Analysis 21.6

Comparison 21 Imiquimod versus placebo: frequency of application, Outcome 6 Minor adverse events excluding skin irritation: digestive: in general.

Comparison 21 Imiquimod versus placebo: frequency of application, Outcome 7 Minor adverse events excluding skin irritation: digestive: nausea.
Figuras y tablas -
Analysis 21.7

Comparison 21 Imiquimod versus placebo: frequency of application, Outcome 7 Minor adverse events excluding skin irritation: digestive: nausea.

Comparison 21 Imiquimod versus placebo: frequency of application, Outcome 8 Minor adverse events excluding skin irritation: nervous system: in general.
Figuras y tablas -
Analysis 21.8

Comparison 21 Imiquimod versus placebo: frequency of application, Outcome 8 Minor adverse events excluding skin irritation: nervous system: in general.

Comparison 21 Imiquimod versus placebo: frequency of application, Outcome 9 Minor adverse events excluding skin irritation: nervous system: headache.
Figuras y tablas -
Analysis 21.9

Comparison 21 Imiquimod versus placebo: frequency of application, Outcome 9 Minor adverse events excluding skin irritation: nervous system: headache.

Comparison 22 5% imiquimod versus 5% 5‐FU, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 22.1

Comparison 22 5% imiquimod versus 5% 5‐FU, Outcome 1 Participant complete clearance.

Comparison 22 5% imiquimod versus 5% 5‐FU, Outcome 2 Cosmetic outcome: Investigator cosmetic outcome "excellent".
Figuras y tablas -
Analysis 22.2

Comparison 22 5% imiquimod versus 5% 5‐FU, Outcome 2 Cosmetic outcome: Investigator cosmetic outcome "excellent".

Comparison 22 5% imiquimod versus 5% 5‐FU, Outcome 3 Cosmetic outcome: normal skin surface.
Figuras y tablas -
Analysis 22.3

Comparison 22 5% imiquimod versus 5% 5‐FU, Outcome 3 Cosmetic outcome: normal skin surface.

Comparison 23 5% imiquimod versus cryotherapy, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 23.1

Comparison 23 5% imiquimod versus cryotherapy, Outcome 1 Participant complete clearance.

Comparison 24 Ingenol mebutate (PEP005) versus placebo, Outcome 1 Participant complete clearance of target lesions.
Figuras y tablas -
Analysis 24.1

Comparison 24 Ingenol mebutate (PEP005) versus placebo, Outcome 1 Participant complete clearance of target lesions.

Comparison 24 Ingenol mebutate (PEP005) versus placebo, Outcome 2 Participant complete clearance of all lesions.
Figuras y tablas -
Analysis 24.2

Comparison 24 Ingenol mebutate (PEP005) versus placebo, Outcome 2 Participant complete clearance of all lesions.

Comparison 24 Ingenol mebutate (PEP005) versus placebo, Outcome 3 Participant partial (>75%) clearance of target lesions.
Figuras y tablas -
Analysis 24.3

Comparison 24 Ingenol mebutate (PEP005) versus placebo, Outcome 3 Participant partial (>75%) clearance of target lesions.

Comparison 24 Ingenol mebutate (PEP005) versus placebo, Outcome 4 Cosmetic outcomes: changes in pigmentation.
Figuras y tablas -
Analysis 24.4

Comparison 24 Ingenol mebutate (PEP005) versus placebo, Outcome 4 Cosmetic outcomes: changes in pigmentation.

Comparison 25 Ingenol mebutate (PEP005) versus placebo: different concentrations, Outcome 1 Participant complete clearance of target lesions.
Figuras y tablas -
Analysis 25.1

Comparison 25 Ingenol mebutate (PEP005) versus placebo: different concentrations, Outcome 1 Participant complete clearance of target lesions.

Comparison 25 Ingenol mebutate (PEP005) versus placebo: different concentrations, Outcome 2 Participant complete clearance of all lesions.
Figuras y tablas -
Analysis 25.2

Comparison 25 Ingenol mebutate (PEP005) versus placebo: different concentrations, Outcome 2 Participant complete clearance of all lesions.

Comparison 25 Ingenol mebutate (PEP005) versus placebo: different concentrations, Outcome 3 Participant partial (>75%) clearance of target lesions.
Figuras y tablas -
Analysis 25.3

Comparison 25 Ingenol mebutate (PEP005) versus placebo: different concentrations, Outcome 3 Participant partial (>75%) clearance of target lesions.

Comparison 25 Ingenol mebutate (PEP005) versus placebo: different concentrations, Outcome 4 Cosmetic outcomes: changes in pigmentation.
Figuras y tablas -
Analysis 25.4

Comparison 25 Ingenol mebutate (PEP005) versus placebo: different concentrations, Outcome 4 Cosmetic outcomes: changes in pigmentation.

Comparison 26 0.05% Ingenol mebutate (PEP005) versus placebo: number of doses, Outcome 1 Participant complete clearance of target lesions.
Figuras y tablas -
Analysis 26.1

Comparison 26 0.05% Ingenol mebutate (PEP005) versus placebo: number of doses, Outcome 1 Participant complete clearance of target lesions.

Comparison 26 0.05% Ingenol mebutate (PEP005) versus placebo: number of doses, Outcome 2 Participant complete clearance of all lesions.
Figuras y tablas -
Analysis 26.2

Comparison 26 0.05% Ingenol mebutate (PEP005) versus placebo: number of doses, Outcome 2 Participant complete clearance of all lesions.

Comparison 26 0.05% Ingenol mebutate (PEP005) versus placebo: number of doses, Outcome 3 Participant partial (>75%) clearance of target lesions.
Figuras y tablas -
Analysis 26.3

Comparison 26 0.05% Ingenol mebutate (PEP005) versus placebo: number of doses, Outcome 3 Participant partial (>75%) clearance of target lesions.

Comparison 27 Isotretinoin versus vehicle, Outcome 1 Investigator global improvement indices‐completely cleared.
Figuras y tablas -
Analysis 27.1

Comparison 27 Isotretinoin versus vehicle, Outcome 1 Investigator global improvement indices‐completely cleared.

Comparison 27 Isotretinoin versus vehicle, Outcome 2 Mean reduction of lesion counts.
Figuras y tablas -
Analysis 27.2

Comparison 27 Isotretinoin versus vehicle, Outcome 2 Mean reduction of lesion counts.

Comparison 27 Isotretinoin versus vehicle, Outcome 3 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 27.3

Comparison 27 Isotretinoin versus vehicle, Outcome 3 Withdrawal due to adverse events.

Comparison 27 Isotretinoin versus vehicle, Outcome 4 Skin irritation.
Figuras y tablas -
Analysis 27.4

Comparison 27 Isotretinoin versus vehicle, Outcome 4 Skin irritation.

Comparison 27 Isotretinoin versus vehicle, Outcome 5 Severe‐Skin irritation.
Figuras y tablas -
Analysis 27.5

Comparison 27 Isotretinoin versus vehicle, Outcome 5 Severe‐Skin irritation.

Comparison 28 Masoprocol versus placebo, Outcome 1 Global improvement indices‐cured.
Figuras y tablas -
Analysis 28.1

Comparison 28 Masoprocol versus placebo, Outcome 1 Global improvement indices‐cured.

Comparison 28 Masoprocol versus placebo, Outcome 2 Mean reduction in lesion counts.
Figuras y tablas -
Analysis 28.2

Comparison 28 Masoprocol versus placebo, Outcome 2 Mean reduction in lesion counts.

Comparison 28 Masoprocol versus placebo, Outcome 3 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 28.3

Comparison 28 Masoprocol versus placebo, Outcome 3 Withdrawal due to adverse events.

Comparison 29 1% nicotinamide versus placebo, Outcome 1 Mean percentage of reduction in lesion counts.
Figuras y tablas -
Analysis 29.1

Comparison 29 1% nicotinamide versus placebo, Outcome 1 Mean percentage of reduction in lesion counts.

Comparison 29 1% nicotinamide versus placebo, Outcome 2 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 29.2

Comparison 29 1% nicotinamide versus placebo, Outcome 2 Withdrawal due to adverse events.

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 30.1

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 1 Participant complete clearance.

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 2 Participant partial (>75%) clearance.
Figuras y tablas -
Analysis 30.2

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 2 Participant partial (>75%) clearance.

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 3 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 30.3

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 3 Withdrawal due to adverse events.

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 4 Minor adverse events excluding skin irritation: body as a whole: fatigue.
Figuras y tablas -
Analysis 30.4

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 4 Minor adverse events excluding skin irritation: body as a whole: fatigue.

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 5 Minor adverse events excluding skin irritation: body as a whole: rigors.
Figuras y tablas -
Analysis 30.5

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 5 Minor adverse events excluding skin irritation: body as a whole: rigors.

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 6 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: in general.
Figuras y tablas -
Analysis 30.6

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 6 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: in general.

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 7 Minor adverse events excluding skin irritation:musculoskeletal and connective tissue: arthralgia.
Figuras y tablas -
Analysis 30.7

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 7 Minor adverse events excluding skin irritation:musculoskeletal and connective tissue: arthralgia.

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 8 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: myalgia.
Figuras y tablas -
Analysis 30.8

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 8 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: myalgia.

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 9 Minor adverse events excluding skin irritation: nervous system: in general.
Figuras y tablas -
Analysis 30.9

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 9 Minor adverse events excluding skin irritation: nervous system: in general.

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 10 Minor adverse events excluding skin irritation: nervous system: headache.
Figuras y tablas -
Analysis 30.10

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 10 Minor adverse events excluding skin irritation: nervous system: headache.

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 11 Minor adverse events excluding skin irritation: nervous system: lethargy.
Figuras y tablas -
Analysis 30.11

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 11 Minor adverse events excluding skin irritation: nervous system: lethargy.

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 12 Minor adverse events excluding skin irritation: nervous system: psychiatric disorders.
Figuras y tablas -
Analysis 30.12

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 12 Minor adverse events excluding skin irritation: nervous system: psychiatric disorders.

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 13 Minor adverse events excluding skin irritation: skin and subcutaneous disorders: in general.
Figuras y tablas -
Analysis 30.13

Comparison 30 0.1% resiquimod versus 0.01% resiquimod, Outcome 13 Minor adverse events excluding skin irritation: skin and subcutaneous disorders: in general.

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 31.1

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 1 Participant complete clearance.

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 2 Participant partial (>75%) clearance.
Figuras y tablas -
Analysis 31.2

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 2 Participant partial (>75%) clearance.

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 3 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 31.3

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 3 Withdrawal due to adverse events.

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 4 Minor adverse events excluding skin irritation: body as a whole: fatigue.
Figuras y tablas -
Analysis 31.4

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 4 Minor adverse events excluding skin irritation: body as a whole: fatigue.

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 5 Minor adverse events excluding skin irritation: body as a whole: rigors.
Figuras y tablas -
Analysis 31.5

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 5 Minor adverse events excluding skin irritation: body as a whole: rigors.

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 6 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: in general.
Figuras y tablas -
Analysis 31.6

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 6 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: in general.

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 7 Minor adverse events excluding skin irritation:musculoskeletal and connective tissue: arthralgia.
Figuras y tablas -
Analysis 31.7

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 7 Minor adverse events excluding skin irritation:musculoskeletal and connective tissue: arthralgia.

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 8 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: myalgia.
Figuras y tablas -
Analysis 31.8

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 8 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: myalgia.

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 9 Minor adverse events excluding skin irritation: nervous system: in general.
Figuras y tablas -
Analysis 31.9

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 9 Minor adverse events excluding skin irritation: nervous system: in general.

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 10 Minor adverse events excluding skin irritation: nervous system: headache.
Figuras y tablas -
Analysis 31.10

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 10 Minor adverse events excluding skin irritation: nervous system: headache.

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 11 Minor adverse events excluding skin irritation: nervous system: lethargy.
Figuras y tablas -
Analysis 31.11

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 11 Minor adverse events excluding skin irritation: nervous system: lethargy.

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 12 Minor adverse events excluding skin irritation: nervous system: psychiatric disorders.
Figuras y tablas -
Analysis 31.12

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 12 Minor adverse events excluding skin irritation: nervous system: psychiatric disorders.

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 13 Minor adverse events excluding skin irritation: skin and subcutaneous disorders: in general.
Figuras y tablas -
Analysis 31.13

Comparison 31 0.1% resiquimod versus 0.03% resiquimod, Outcome 13 Minor adverse events excluding skin irritation: skin and subcutaneous disorders: in general.

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 32.1

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 1 Participant complete clearance.

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 2 Participant partial (>75%) clearance.
Figuras y tablas -
Analysis 32.2

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 2 Participant partial (>75%) clearance.

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 3 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 32.3

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 3 Withdrawal due to adverse events.

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 4 Minor adverse events excluding skin irritation: body as a whole: fatigue.
Figuras y tablas -
Analysis 32.4

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 4 Minor adverse events excluding skin irritation: body as a whole: fatigue.

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 5 Minor adverse events excluding skin irritation: body as a whole: rigors.
Figuras y tablas -
Analysis 32.5

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 5 Minor adverse events excluding skin irritation: body as a whole: rigors.

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 6 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: in general.
Figuras y tablas -
Analysis 32.6

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 6 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: in general.

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 7 Minor adverse events excluding skin irritation:musculoskeletal and connective tissue: arthralgia.
Figuras y tablas -
Analysis 32.7

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 7 Minor adverse events excluding skin irritation:musculoskeletal and connective tissue: arthralgia.

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 8 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: myalgia.
Figuras y tablas -
Analysis 32.8

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 8 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: myalgia.

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 9 Minor adverse events excluding skin irritation: nervous system: in general.
Figuras y tablas -
Analysis 32.9

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 9 Minor adverse events excluding skin irritation: nervous system: in general.

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 10 Minor adverse events excluding skin irritation: nervous system: headache.
Figuras y tablas -
Analysis 32.10

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 10 Minor adverse events excluding skin irritation: nervous system: headache.

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 11 Minor adverse events excluding skin irritation: nervous system: lethargy.
Figuras y tablas -
Analysis 32.11

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 11 Minor adverse events excluding skin irritation: nervous system: lethargy.

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 12 Minor adverse events excluding skin irritation: nervous system: psychiatric disorders.
Figuras y tablas -
Analysis 32.12

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 12 Minor adverse events excluding skin irritation: nervous system: psychiatric disorders.

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 13 Minor adverse events excluding skin irritation: skin and subcutaneous disorders: in general.
Figuras y tablas -
Analysis 32.13

Comparison 32 0.1% resiquimod versus 0.06% resiquimod, Outcome 13 Minor adverse events excluding skin irritation: skin and subcutaneous disorders: in general.

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 33.1

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 1 Participant complete clearance.

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 2 Participant partial (>75%) clearance.
Figuras y tablas -
Analysis 33.2

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 2 Participant partial (>75%) clearance.

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 3 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 33.3

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 3 Withdrawal due to adverse events.

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 4 Minor adverse events excluding skin irritation: body as a whole: fatigue.
Figuras y tablas -
Analysis 33.4

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 4 Minor adverse events excluding skin irritation: body as a whole: fatigue.

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 5 Minor adverse events excluding skin irritation: body as a whole: rigors.
Figuras y tablas -
Analysis 33.5

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 5 Minor adverse events excluding skin irritation: body as a whole: rigors.

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 6 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: in general.
Figuras y tablas -
Analysis 33.6

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 6 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: in general.

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 7 Minor adverse events excluding skin irritation:musculoskeletal and connective tissue: arthralgia.
Figuras y tablas -
Analysis 33.7

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 7 Minor adverse events excluding skin irritation:musculoskeletal and connective tissue: arthralgia.

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 8 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: myalgia.
Figuras y tablas -
Analysis 33.8

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 8 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: myalgia.

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 9 Minor adverse events excluding skin irritation: nervous system: in general.
Figuras y tablas -
Analysis 33.9

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 9 Minor adverse events excluding skin irritation: nervous system: in general.

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 10 Minor adverse events excluding skin irritation: nervous system: headache.
Figuras y tablas -
Analysis 33.10

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 10 Minor adverse events excluding skin irritation: nervous system: headache.

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 11 Minor adverse events excluding skin irritation: nervous system: lethargy.
Figuras y tablas -
Analysis 33.11

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 11 Minor adverse events excluding skin irritation: nervous system: lethargy.

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 12 Minor adverse events excluding skin irritation: nervous system: psychiatric disorders.
Figuras y tablas -
Analysis 33.12

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 12 Minor adverse events excluding skin irritation: nervous system: psychiatric disorders.

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 13 Minor adverse events excluding skin irritation: skin and subcutaneous disorders: in general.
Figuras y tablas -
Analysis 33.13

Comparison 33 0.06% resiquimod versus 0.01% resiquimod, Outcome 13 Minor adverse events excluding skin irritation: skin and subcutaneous disorders: in general.

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 34.1

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 1 Participant complete clearance.

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 2 Participant partial (>75%) clearance.
Figuras y tablas -
Analysis 34.2

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 2 Participant partial (>75%) clearance.

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 3 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 34.3

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 3 Withdrawal due to adverse events.

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 4 Minor adverse events excluding skin irritation: body as a whole: fatigue.
Figuras y tablas -
Analysis 34.4

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 4 Minor adverse events excluding skin irritation: body as a whole: fatigue.

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 5 Minor adverse events excluding skin irritation: body as a whole: rigors.
Figuras y tablas -
Analysis 34.5

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 5 Minor adverse events excluding skin irritation: body as a whole: rigors.

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 6 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: in general.
Figuras y tablas -
Analysis 34.6

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 6 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: in general.

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 7 Minor adverse events excluding skin irritation:musculoskeletal and connective tissue: arthralgia.
Figuras y tablas -
Analysis 34.7

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 7 Minor adverse events excluding skin irritation:musculoskeletal and connective tissue: arthralgia.

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 8 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: myalgia.
Figuras y tablas -
Analysis 34.8

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 8 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: myalgia.

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 9 Minor adverse events excluding skin irritation: nervous system: in general.
Figuras y tablas -
Analysis 34.9

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 9 Minor adverse events excluding skin irritation: nervous system: in general.

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 10 Minor adverse events excluding skin irritation: nervous system: headache.
Figuras y tablas -
Analysis 34.10

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 10 Minor adverse events excluding skin irritation: nervous system: headache.

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 11 Minor adverse events excluding skin irritation: nervous system: lethargy.
Figuras y tablas -
Analysis 34.11

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 11 Minor adverse events excluding skin irritation: nervous system: lethargy.

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 12 Minor adverse events excluding skin irritation: nervous system: psychiatric disorders.
Figuras y tablas -
Analysis 34.12

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 12 Minor adverse events excluding skin irritation: nervous system: psychiatric disorders.

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 13 Minor adverse events excluding skin irritation:skin and subcutaneous disorders: in general.
Figuras y tablas -
Analysis 34.13

Comparison 34 0.06% resiquimod versus 0.03% resiquimod, Outcome 13 Minor adverse events excluding skin irritation:skin and subcutaneous disorders: in general.

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 35.1

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 1 Participant complete clearance.

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 2 Participant partial (>75%) clearance.
Figuras y tablas -
Analysis 35.2

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 2 Participant partial (>75%) clearance.

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 3 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 35.3

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 3 Withdrawal due to adverse events.

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 4 Minor adverse events excluding skin irritation: body as a whole: fatigue.
Figuras y tablas -
Analysis 35.4

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 4 Minor adverse events excluding skin irritation: body as a whole: fatigue.

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 5 Minor adverse events excluding skin irritation: body as a whole: rigors.
Figuras y tablas -
Analysis 35.5

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 5 Minor adverse events excluding skin irritation: body as a whole: rigors.

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 6 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: in general.
Figuras y tablas -
Analysis 35.6

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 6 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: in general.

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 7 Minor adverse events excluding skin irritation:musculoskeletal and connective tissue: arthralgia.
Figuras y tablas -
Analysis 35.7

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 7 Minor adverse events excluding skin irritation:musculoskeletal and connective tissue: arthralgia.

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 8 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: myalgia.
Figuras y tablas -
Analysis 35.8

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 8 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: myalgia.

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 9 Minor adverse events excluding skin irritation: nervous system: in general.
Figuras y tablas -
Analysis 35.9

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 9 Minor adverse events excluding skin irritation: nervous system: in general.

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 10 Minor adverse events excluding skin irritation: nervous system: headache.
Figuras y tablas -
Analysis 35.10

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 10 Minor adverse events excluding skin irritation: nervous system: headache.

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 11 Minor adverse events excluding skin irritation: nervous system: lethargy.
Figuras y tablas -
Analysis 35.11

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 11 Minor adverse events excluding skin irritation: nervous system: lethargy.

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 12 Minor adverse events excluding skin irritation: nervous system: psychiatric disorders.
Figuras y tablas -
Analysis 35.12

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 12 Minor adverse events excluding skin irritation: nervous system: psychiatric disorders.

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 13 Minor adverse events excluding skin irritation: skin and subcutaneous disorders: in general.
Figuras y tablas -
Analysis 35.13

Comparison 35 0.03% resiquimod versus 0.01% resiquimod, Outcome 13 Minor adverse events excluding skin irritation: skin and subcutaneous disorders: in general.

Comparison 36 Sunscreen SPF 17 (8% 2‐ethyl‐hexyl p‐methoxycinnamate/2% 4‐tert‐butyl‐4‐methoxy‐4‐dibenzoylmethane) versus placebo, Outcome 1 Mean change in lesion counts.
Figuras y tablas -
Analysis 36.1

Comparison 36 Sunscreen SPF 17 (8% 2‐ethyl‐hexyl p‐methoxycinnamate/2% 4‐tert‐butyl‐4‐methoxy‐4‐dibenzoylmethane) versus placebo, Outcome 1 Mean change in lesion counts.

Comparison 37 12.5% DL‐α‐tocopherol (vitamin E) versus placebo, Outcome 1 Mean reduction of lesion counts.
Figuras y tablas -
Analysis 37.1

Comparison 37 12.5% DL‐α‐tocopherol (vitamin E) versus placebo, Outcome 1 Mean reduction of lesion counts.

Comparison 38 Etretinate versus placebo, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 38.1

Comparison 38 Etretinate versus placebo, Outcome 1 Participant complete clearance.

Comparison 39 Carbon dioxide laser resurfacing versus 5% 5‐FU, Outcome 1 Mean percentage of reduction of lesion counts.
Figuras y tablas -
Analysis 39.1

Comparison 39 Carbon dioxide laser resurfacing versus 5% 5‐FU, Outcome 1 Mean percentage of reduction of lesion counts.

Comparison 39 Carbon dioxide laser resurfacing versus 5% 5‐FU, Outcome 2 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 39.2

Comparison 39 Carbon dioxide laser resurfacing versus 5% 5‐FU, Outcome 2 Withdrawal due to adverse events.

Comparison 40 Carbon dioxide laser resurfacing versus Trichloroacetic acid peel, Outcome 1 Mean percentage of reduction of lesion counts.
Figuras y tablas -
Analysis 40.1

Comparison 40 Carbon dioxide laser resurfacing versus Trichloroacetic acid peel, Outcome 1 Mean percentage of reduction of lesion counts.

Comparison 40 Carbon dioxide laser resurfacing versus Trichloroacetic acid peel, Outcome 2 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 40.2

Comparison 40 Carbon dioxide laser resurfacing versus Trichloroacetic acid peel, Outcome 2 Withdrawal due to adverse events.

Study

Intervention

At 3 months

At 6 months

At 12 months

Ostertag 2006

5‐fluorouracil

13.2

12.5

12.4

Ostertag 2006

Er:YAG laser resurfacing

13.8

13.9

14.2

Figuras y tablas -
Analysis 41.1

Comparison 41 Er:YAG laser resurfacing versus 5% 5‐FU, Outcome 1 Mean reduction in lesion counts.

Study

Assessment

Resurfacing

5‐FU

Ostertag 2006

At 6 months

94.4%

79.2%

Ostertag 2006

At 12 months

91.1%

76.6%

Figuras y tablas -
Analysis 41.2

Comparison 41 Er:YAG laser resurfacing versus 5% 5‐FU, Outcome 2 Mean percentage of reduction in lesion counts.

Comparison 41 Er:YAG laser resurfacing versus 5% 5‐FU, Outcome 3 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 41.3

Comparison 41 Er:YAG laser resurfacing versus 5% 5‐FU, Outcome 3 Withdrawal due to adverse events.

Comparison 41 Er:YAG laser resurfacing versus 5% 5‐FU, Outcome 4 Skin irritation.
Figuras y tablas -
Analysis 41.4

Comparison 41 Er:YAG laser resurfacing versus 5% 5‐FU, Outcome 4 Skin irritation.

Comparison 41 Er:YAG laser resurfacing versus 5% 5‐FU, Outcome 5 Minor adverse events excluding skin irritation: dermatology: acne.
Figuras y tablas -
Analysis 41.5

Comparison 41 Er:YAG laser resurfacing versus 5% 5‐FU, Outcome 5 Minor adverse events excluding skin irritation: dermatology: acne.

Comparison 41 Er:YAG laser resurfacing versus 5% 5‐FU, Outcome 6 Minor adverse events excluding skin irritation: dermatology:crustea.
Figuras y tablas -
Analysis 41.6

Comparison 41 Er:YAG laser resurfacing versus 5% 5‐FU, Outcome 6 Minor adverse events excluding skin irritation: dermatology:crustea.

Comparison 41 Er:YAG laser resurfacing versus 5% 5‐FU, Outcome 7 Minor adverse events excluding skin irritation: dermatology: infection.
Figuras y tablas -
Analysis 41.7

Comparison 41 Er:YAG laser resurfacing versus 5% 5‐FU, Outcome 7 Minor adverse events excluding skin irritation: dermatology: infection.

Comparison 41 Er:YAG laser resurfacing versus 5% 5‐FU, Outcome 8 Minor adverse events excluding skin irritation: dermatology: milia.
Figuras y tablas -
Analysis 41.8

Comparison 41 Er:YAG laser resurfacing versus 5% 5‐FU, Outcome 8 Minor adverse events excluding skin irritation: dermatology: milia.

Comparison 41 Er:YAG laser resurfacing versus 5% 5‐FU, Outcome 9 Minor adverse events excluding skin irritation: dermatology:pain.
Figuras y tablas -
Analysis 41.9

Comparison 41 Er:YAG laser resurfacing versus 5% 5‐FU, Outcome 9 Minor adverse events excluding skin irritation: dermatology:pain.

Comparison 41 Er:YAG laser resurfacing versus 5% 5‐FU, Outcome 10 Cosmetic outcomes: changes in pigmentation (hypo).
Figuras y tablas -
Analysis 41.10

Comparison 41 Er:YAG laser resurfacing versus 5% 5‐FU, Outcome 10 Cosmetic outcomes: changes in pigmentation (hypo).

Comparison 41 Er:YAG laser resurfacing versus 5% 5‐FU, Outcome 11 Cosmetic outcomes: scarring.
Figuras y tablas -
Analysis 41.11

Comparison 41 Er:YAG laser resurfacing versus 5% 5‐FU, Outcome 11 Cosmetic outcomes: scarring.

Comparison 41 Er:YAG laser resurfacing versus 5% 5‐FU, Outcome 12 Cosmetic outcomes: improvement in photoageing score.
Figuras y tablas -
Analysis 41.12

Comparison 41 Er:YAG laser resurfacing versus 5% 5‐FU, Outcome 12 Cosmetic outcomes: improvement in photoageing score.

Comparison 42 Cryotherapy versus betulin‐based oleogel, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 42.1

Comparison 42 Cryotherapy versus betulin‐based oleogel, Outcome 1 Participant complete clearance.

Comparison 42 Cryotherapy versus betulin‐based oleogel, Outcome 2 Participant partial (>75%) clearance.
Figuras y tablas -
Analysis 42.2

Comparison 42 Cryotherapy versus betulin‐based oleogel, Outcome 2 Participant partial (>75%) clearance.

Comparison 43 Cryotherapy versus 5% 5‐FU, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 43.1

Comparison 43 Cryotherapy versus 5% 5‐FU, Outcome 1 Participant complete clearance.

Comparison 43 Cryotherapy versus 5% 5‐FU, Outcome 2 Cosmetic outcomes: excellent global cosmetic outcome.
Figuras y tablas -
Analysis 43.2

Comparison 43 Cryotherapy versus 5% 5‐FU, Outcome 2 Cosmetic outcomes: excellent global cosmetic outcome.

Comparison 43 Cryotherapy versus 5% 5‐FU, Outcome 3 Cosmetic outcomes: better skin appearance.
Figuras y tablas -
Analysis 43.3

Comparison 43 Cryotherapy versus 5% 5‐FU, Outcome 3 Cosmetic outcomes: better skin appearance.

Comparison 44 Cryotherapy versus imiquimod, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 44.1

Comparison 44 Cryotherapy versus imiquimod, Outcome 1 Participant complete clearance.

Comparison 44 Cryotherapy versus imiquimod, Outcome 2 Cosmetic outcomes: excellent global cosmetic outcome.
Figuras y tablas -
Analysis 44.2

Comparison 44 Cryotherapy versus imiquimod, Outcome 2 Cosmetic outcomes: excellent global cosmetic outcome.

Comparison 44 Cryotherapy versus imiquimod, Outcome 3 Cosmetic outcomes: better skin appearance.
Figuras y tablas -
Analysis 44.3

Comparison 44 Cryotherapy versus imiquimod, Outcome 3 Cosmetic outcomes: better skin appearance.

Study

Assessment at

Cryotherapy

MAL‐PDT

Kaufmann 2008

12 weeks

N/A

N/A

Kaufmann 2008

24 weeks

87%

75%

Morton 2006

12 weeks

74.5%

84.4%

Morton 2006

24 weeks

83.9%

86.7%

Figuras y tablas -
Analysis 45.1

Comparison 45 Cryotherapy versus MAL‐red light PDT, Outcome 1 Mean percentage of reduction in lesion counts.

Comparison 45 Cryotherapy versus MAL‐red light PDT, Outcome 2 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 45.2

Comparison 45 Cryotherapy versus MAL‐red light PDT, Outcome 2 Withdrawal due to adverse events.

Comparison 45 Cryotherapy versus MAL‐red light PDT, Outcome 3 Cosmetic outcomes: excellent or good cosmetic outcomes by investigator.
Figuras y tablas -
Analysis 45.3

Comparison 45 Cryotherapy versus MAL‐red light PDT, Outcome 3 Cosmetic outcomes: excellent or good cosmetic outcomes by investigator.

Comparison 45 Cryotherapy versus MAL‐red light PDT, Outcome 4 Cosmetic outcomes: excellent or good cosmetic outcomes by participant.
Figuras y tablas -
Analysis 45.4

Comparison 45 Cryotherapy versus MAL‐red light PDT, Outcome 4 Cosmetic outcomes: excellent or good cosmetic outcomes by participant.

Comparison 46 Cryotherapy versus ALA‐red light PDT, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 46.1

Comparison 46 Cryotherapy versus ALA‐red light PDT, Outcome 1 Participant complete clearance.

Comparison 46 Cryotherapy versus ALA‐red light PDT, Outcome 2 Skin irritation.
Figuras y tablas -
Analysis 46.2

Comparison 46 Cryotherapy versus ALA‐red light PDT, Outcome 2 Skin irritation.

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 1 Participant complete clearance [1 treatment].
Figuras y tablas -
Analysis 47.1

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 1 Participant complete clearance [1 treatment].

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 2 Participant complete clearance [1 or 2 treatments].
Figuras y tablas -
Analysis 47.2

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 2 Participant complete clearance [1 or 2 treatments].

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 3 Participant complete clearance [1 or 2 treatments] by anatomical location.
Figuras y tablas -
Analysis 47.3

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 3 Participant complete clearance [1 or 2 treatments] by anatomical location.

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 4 Participant partial (> 75%) clearance [1 treatment].
Figuras y tablas -
Analysis 47.4

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 4 Participant partial (> 75%) clearance [1 treatment].

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 5 Participant partial (>75%) clearance[1 or 2 treatments].
Figuras y tablas -
Analysis 47.5

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 5 Participant partial (>75%) clearance[1 or 2 treatments].

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 6 Participant partial (>75%) clearance [1 or 2 treatment] by anatomical location.
Figuras y tablas -
Analysis 47.6

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 6 Participant partial (>75%) clearance [1 or 2 treatment] by anatomical location.

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 7 Skin irritation.
Figuras y tablas -
Analysis 47.7

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 7 Skin irritation.

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 8 Minor adverse events excluding skin irritation: body as a whole: injury.
Figuras y tablas -
Analysis 47.8

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 8 Minor adverse events excluding skin irritation: body as a whole: injury.

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 9 Minor adverse events excluding skin irritation: cardiovascular: hypertension.
Figuras y tablas -
Analysis 47.9

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 9 Minor adverse events excluding skin irritation: cardiovascular: hypertension.

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 10 Minor adverse events excluding skin irritation: dermatology: skin discolouration.
Figuras y tablas -
Analysis 47.10

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 10 Minor adverse events excluding skin irritation: dermatology: skin discolouration.

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 11 Minor adverse events excluding skin irritation: dermatology: skin hypertrophy.
Figuras y tablas -
Analysis 47.11

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 11 Minor adverse events excluding skin irritation: dermatology: skin hypertrophy.

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 12 Minor adverse events excluding skin irritation: nervous system: headache.
Figuras y tablas -
Analysis 47.12

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 12 Minor adverse events excluding skin irritation: nervous system: headache.

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 13 Cosmetic outcome: very good or good general cosmetic outcome.
Figuras y tablas -
Analysis 47.13

Comparison 47 ALA‐PDT versus placebo‐PDT, Outcome 13 Cosmetic outcome: very good or good general cosmetic outcome.

Comparison 48 ALA‐ blue light PDT versus ALA‐pulsed laser PDT, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 48.1

Comparison 48 ALA‐ blue light PDT versus ALA‐pulsed laser PDT, Outcome 1 Participant complete clearance.

Comparison 48 ALA‐ blue light PDT versus ALA‐pulsed laser PDT, Outcome 2 Participant partial (>75%) clearance.
Figuras y tablas -
Analysis 48.2

Comparison 48 ALA‐ blue light PDT versus ALA‐pulsed laser PDT, Outcome 2 Participant partial (>75%) clearance.

Comparison 48 ALA‐ blue light PDT versus ALA‐pulsed laser PDT, Outcome 3 Cosmetic outcome: improvement in global response.
Figuras y tablas -
Analysis 48.3

Comparison 48 ALA‐ blue light PDT versus ALA‐pulsed laser PDT, Outcome 3 Cosmetic outcome: improvement in global response.

Comparison 48 ALA‐ blue light PDT versus ALA‐pulsed laser PDT, Outcome 4 Cosmetic outcome: improvement in tactile roughness.
Figuras y tablas -
Analysis 48.4

Comparison 48 ALA‐ blue light PDT versus ALA‐pulsed laser PDT, Outcome 4 Cosmetic outcome: improvement in tactile roughness.

Comparison 48 ALA‐ blue light PDT versus ALA‐pulsed laser PDT, Outcome 5 Cosmetic outcome: improvement in mottled hyperpigmentation.
Figuras y tablas -
Analysis 48.5

Comparison 48 ALA‐ blue light PDT versus ALA‐pulsed laser PDT, Outcome 5 Cosmetic outcome: improvement in mottled hyperpigmentation.

Comparison 49 ALA‐red light PDT at different application times, Outcome 1 Participant complete clearance at 4 weeks.
Figuras y tablas -
Analysis 49.1

Comparison 49 ALA‐red light PDT at different application times, Outcome 1 Participant complete clearance at 4 weeks.

Comparison 49 ALA‐red light PDT at different application times, Outcome 2 Participant complete clearance at 8 weeks.
Figuras y tablas -
Analysis 49.2

Comparison 49 ALA‐red light PDT at different application times, Outcome 2 Participant complete clearance at 8 weeks.

Comparison 49 ALA‐red light PDT at different application times, Outcome 3 Minor adverse events excluding skin irritation: metabolic and nutritional disorders: elevated alanine transaminase (ALT).
Figuras y tablas -
Analysis 49.3

Comparison 49 ALA‐red light PDT at different application times, Outcome 3 Minor adverse events excluding skin irritation: metabolic and nutritional disorders: elevated alanine transaminase (ALT).

Comparison 49 ALA‐red light PDT at different application times, Outcome 4 Minor adverse events excluding skin irritation: nervous system: headache.
Figuras y tablas -
Analysis 49.4

Comparison 49 ALA‐red light PDT at different application times, Outcome 4 Minor adverse events excluding skin irritation: nervous system: headache.

Comparison 49 ALA‐red light PDT at different application times, Outcome 5 Minor adverse events excluding skin irritation: other: epistaxis (nose bleeding).
Figuras y tablas -
Analysis 49.5

Comparison 49 ALA‐red light PDT at different application times, Outcome 5 Minor adverse events excluding skin irritation: other: epistaxis (nose bleeding).

Comparison 50 ALA‐PDT versus 0.5% 5‐FU, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 50.1

Comparison 50 ALA‐PDT versus 0.5% 5‐FU, Outcome 1 Participant complete clearance.

Comparison 50 ALA‐PDT versus 0.5% 5‐FU, Outcome 2 Participant partial (>75%) clearance.
Figuras y tablas -
Analysis 50.2

Comparison 50 ALA‐PDT versus 0.5% 5‐FU, Outcome 2 Participant partial (>75%) clearance.

Comparison 50 ALA‐PDT versus 0.5% 5‐FU, Outcome 3 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 50.3

Comparison 50 ALA‐PDT versus 0.5% 5‐FU, Outcome 3 Withdrawal due to adverse events.

Comparison 50 ALA‐PDT versus 0.5% 5‐FU, Outcome 4 Cosmetic outcome: improvement in global response.
Figuras y tablas -
Analysis 50.4

Comparison 50 ALA‐PDT versus 0.5% 5‐FU, Outcome 4 Cosmetic outcome: improvement in global response.

Comparison 50 ALA‐PDT versus 0.5% 5‐FU, Outcome 5 Cosmetic outcome: improvement in tactile roughness.
Figuras y tablas -
Analysis 50.5

Comparison 50 ALA‐PDT versus 0.5% 5‐FU, Outcome 5 Cosmetic outcome: improvement in tactile roughness.

Comparison 50 ALA‐PDT versus 0.5% 5‐FU, Outcome 6 Cosmetic outcome: improvement in mottled hyperpigmentation.
Figuras y tablas -
Analysis 50.6

Comparison 50 ALA‐PDT versus 0.5% 5‐FU, Outcome 6 Cosmetic outcome: improvement in mottled hyperpigmentation.

Comparison 51 ALA‐red light PDT vs cryotherapy, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 51.1

Comparison 51 ALA‐red light PDT vs cryotherapy, Outcome 1 Participant complete clearance.

Comparison 51 ALA‐red light PDT vs cryotherapy, Outcome 2 Skin irritation.
Figuras y tablas -
Analysis 51.2

Comparison 51 ALA‐red light PDT vs cryotherapy, Outcome 2 Skin irritation.

Comparison 52 MAL‐red light PDT versus placebo‐red light PDT, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 52.1

Comparison 52 MAL‐red light PDT versus placebo‐red light PDT, Outcome 1 Participant complete clearance.

Comparison 52 MAL‐red light PDT versus placebo‐red light PDT, Outcome 2 Participant partial (>75%) clearance.
Figuras y tablas -
Analysis 52.2

Comparison 52 MAL‐red light PDT versus placebo‐red light PDT, Outcome 2 Participant partial (>75%) clearance.

Comparison 52 MAL‐red light PDT versus placebo‐red light PDT, Outcome 3 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 52.3

Comparison 52 MAL‐red light PDT versus placebo‐red light PDT, Outcome 3 Withdrawal due to adverse events.

Comparison 52 MAL‐red light PDT versus placebo‐red light PDT, Outcome 4 Minor adverse event: nervous system: headache.
Figuras y tablas -
Analysis 52.4

Comparison 52 MAL‐red light PDT versus placebo‐red light PDT, Outcome 4 Minor adverse event: nervous system: headache.

Comparison 52 MAL‐red light PDT versus placebo‐red light PDT, Outcome 5 Cosmetic outcome: hyperpigmentation.
Figuras y tablas -
Analysis 52.5

Comparison 52 MAL‐red light PDT versus placebo‐red light PDT, Outcome 5 Cosmetic outcome: hyperpigmentation.

Comparison 53 MAL‐red light LED PDT versus MAL‐broad visible + water‐filtered infrared A PDT (1 or 2 treatments), Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 53.1

Comparison 53 MAL‐red light LED PDT versus MAL‐broad visible + water‐filtered infrared A PDT (1 or 2 treatments), Outcome 1 Participant complete clearance.

Comparison 53 MAL‐red light LED PDT versus MAL‐broad visible + water‐filtered infrared A PDT (1 or 2 treatments), Outcome 2 Participant partial (>75%) clearance.
Figuras y tablas -
Analysis 53.2

Comparison 53 MAL‐red light LED PDT versus MAL‐broad visible + water‐filtered infrared A PDT (1 or 2 treatments), Outcome 2 Participant partial (>75%) clearance.

Comparison 54 MAL‐red light LED PDT versus MAL‐daylight PDT, Outcome 1 Mean reduction in lesion counts.
Figuras y tablas -
Analysis 54.1

Comparison 54 MAL‐red light LED PDT versus MAL‐daylight PDT, Outcome 1 Mean reduction in lesion counts.

Comparison 55 2h MAL‐day light PDT versus 3h MAL‐daylight PDT, Outcome 1 Mean reduction in lesion counts.
Figuras y tablas -
Analysis 55.1

Comparison 55 2h MAL‐day light PDT versus 3h MAL‐daylight PDT, Outcome 1 Mean reduction in lesion counts.

Comparison 55 2h MAL‐day light PDT versus 3h MAL‐daylight PDT, Outcome 2 Mean percentage of reduction in lesion counts.
Figuras y tablas -
Analysis 55.2

Comparison 55 2h MAL‐day light PDT versus 3h MAL‐daylight PDT, Outcome 2 Mean percentage of reduction in lesion counts.

Comparison 56 16% MAL‐daylight PDT versus 8% MAL‐daylight PDT, Outcome 1 Mean reduction in lesion counts.
Figuras y tablas -
Analysis 56.1

Comparison 56 16% MAL‐daylight PDT versus 8% MAL‐daylight PDT, Outcome 1 Mean reduction in lesion counts.

Comparison 57 Single MAL‐red light PDT versus multiple MAL‐red light PDT (2 treatments 1 week apart), Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 57.1

Comparison 57 Single MAL‐red light PDT versus multiple MAL‐red light PDT (2 treatments 1 week apart), Outcome 1 Participant complete clearance.

Comparison 57 Single MAL‐red light PDT versus multiple MAL‐red light PDT (2 treatments 1 week apart), Outcome 2 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 57.2

Comparison 57 Single MAL‐red light PDT versus multiple MAL‐red light PDT (2 treatments 1 week apart), Outcome 2 Withdrawal due to adverse events.

Comparison 58 MAL‐ red light PDT vs cryotherapy, Outcome 1 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 58.1

Comparison 58 MAL‐ red light PDT vs cryotherapy, Outcome 1 Withdrawal due to adverse events.

Comparison 59 ALA‐red light PDT versus MAL‐red light PDT, Outcome 1 Mean reduction in lesion counts.
Figuras y tablas -
Analysis 59.1

Comparison 59 ALA‐red light PDT versus MAL‐red light PDT, Outcome 1 Mean reduction in lesion counts.

Comparison 60 Trichloroacetic acid peel versus 5% 5‐FU, Outcome 1 Mean percentage of reduction in lesions.
Figuras y tablas -
Analysis 60.1

Comparison 60 Trichloroacetic acid peel versus 5% 5‐FU, Outcome 1 Mean percentage of reduction in lesions.

Comparison 61 Cryotherapy versus cryotherapy with betulin‐based oleogel, Outcome 1 Participant complete clearance.
Figuras y tablas -
Analysis 61.1

Comparison 61 Cryotherapy versus cryotherapy with betulin‐based oleogel, Outcome 1 Participant complete clearance.

Comparison 61 Cryotherapy versus cryotherapy with betulin‐based oleogel, Outcome 2 Participant partial (>75%) clearance.
Figuras y tablas -
Analysis 61.2

Comparison 61 Cryotherapy versus cryotherapy with betulin‐based oleogel, Outcome 2 Participant partial (>75%) clearance.

Comparison 62 (0.5% 5‐FU + cryotherapy) versus (vehicle + cryotherapy), Outcome 1 Participant complete clearance at 6 months.
Figuras y tablas -
Analysis 62.1

Comparison 62 (0.5% 5‐FU + cryotherapy) versus (vehicle + cryotherapy), Outcome 1 Participant complete clearance at 6 months.

Comparison 62 (0.5% 5‐FU + cryotherapy) versus (vehicle + cryotherapy), Outcome 2 Mean reduction in lesion counts at 6 months.
Figuras y tablas -
Analysis 62.2

Comparison 62 (0.5% 5‐FU + cryotherapy) versus (vehicle + cryotherapy), Outcome 2 Mean reduction in lesion counts at 6 months.

Comparison 62 (0.5% 5‐FU + cryotherapy) versus (vehicle + cryotherapy), Outcome 3 Mean percentage of reduction in lesion counts at 6 months.
Figuras y tablas -
Analysis 62.3

Comparison 62 (0.5% 5‐FU + cryotherapy) versus (vehicle + cryotherapy), Outcome 3 Mean percentage of reduction in lesion counts at 6 months.

Comparison 62 (0.5% 5‐FU + cryotherapy) versus (vehicle + cryotherapy), Outcome 4 Minor adverse events excluding skin irritation: body as a whole: allergic reaction.
Figuras y tablas -
Analysis 62.4

Comparison 62 (0.5% 5‐FU + cryotherapy) versus (vehicle + cryotherapy), Outcome 4 Minor adverse events excluding skin irritation: body as a whole: allergic reaction.

Comparison 62 (0.5% 5‐FU + cryotherapy) versus (vehicle + cryotherapy), Outcome 5 Minor adverse events excluding skin irritation: dermatology: hyperesthesia.
Figuras y tablas -
Analysis 62.5

Comparison 62 (0.5% 5‐FU + cryotherapy) versus (vehicle + cryotherapy), Outcome 5 Minor adverse events excluding skin irritation: dermatology: hyperesthesia.

Comparison 62 (0.5% 5‐FU + cryotherapy) versus (vehicle + cryotherapy), Outcome 6 Minor adverse events excluding skin irritation: dermatology: skin discoloration.
Figuras y tablas -
Analysis 62.6

Comparison 62 (0.5% 5‐FU + cryotherapy) versus (vehicle + cryotherapy), Outcome 6 Minor adverse events excluding skin irritation: dermatology: skin discoloration.

Comparison 62 (0.5% 5‐FU + cryotherapy) versus (vehicle + cryotherapy), Outcome 7 Minor adverse events excluding skin irritation: dermatology: vesiculobullous rash.
Figuras y tablas -
Analysis 62.7

Comparison 62 (0.5% 5‐FU + cryotherapy) versus (vehicle + cryotherapy), Outcome 7 Minor adverse events excluding skin irritation: dermatology: vesiculobullous rash.

Comparison 62 (0.5% 5‐FU + cryotherapy) versus (vehicle + cryotherapy), Outcome 8 Minor adverse events excluding skin irritation: digestive: cheilitis.
Figuras y tablas -
Analysis 62.8

Comparison 62 (0.5% 5‐FU + cryotherapy) versus (vehicle + cryotherapy), Outcome 8 Minor adverse events excluding skin irritation: digestive: cheilitis.

Comparison 62 (0.5% 5‐FU + cryotherapy) versus (vehicle + cryotherapy), Outcome 9 Minor adverse events excluding skin irritation: special senses: conjunctivitis.
Figuras y tablas -
Analysis 62.9

Comparison 62 (0.5% 5‐FU + cryotherapy) versus (vehicle + cryotherapy), Outcome 9 Minor adverse events excluding skin irritation: special senses: conjunctivitis.

Comparison 62 (0.5% 5‐FU + cryotherapy) versus (vehicle + cryotherapy), Outcome 10 Minor adverse events excluding skin irritation: special senses: eye irritation.
Figuras y tablas -
Analysis 62.10

Comparison 62 (0.5% 5‐FU + cryotherapy) versus (vehicle + cryotherapy), Outcome 10 Minor adverse events excluding skin irritation: special senses: eye irritation.

Comparison 63 (vehicle + cryotherapy) versus (0.5% 5‐FU + cryotherapy), Outcome 1 Participant complete clearance at 6 months.
Figuras y tablas -
Analysis 63.1

Comparison 63 (vehicle + cryotherapy) versus (0.5% 5‐FU + cryotherapy), Outcome 1 Participant complete clearance at 6 months.

Comparison 63 (vehicle + cryotherapy) versus (0.5% 5‐FU + cryotherapy), Outcome 2 Mean reduction in lesion counts at 6 months.
Figuras y tablas -
Analysis 63.2

Comparison 63 (vehicle + cryotherapy) versus (0.5% 5‐FU + cryotherapy), Outcome 2 Mean reduction in lesion counts at 6 months.

Comparison 63 (vehicle + cryotherapy) versus (0.5% 5‐FU + cryotherapy), Outcome 3 Mean percentage of reduction in lesion counts at 6 months.
Figuras y tablas -
Analysis 63.3

Comparison 63 (vehicle + cryotherapy) versus (0.5% 5‐FU + cryotherapy), Outcome 3 Mean percentage of reduction in lesion counts at 6 months.

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 1 Participant complete clearance of all lesions.
Figuras y tablas -
Analysis 64.1

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 1 Participant complete clearance of all lesions.

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 2 Participant complete clearance of target (cryotherapy treated) lesions.
Figuras y tablas -
Analysis 64.2

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 2 Participant complete clearance of target (cryotherapy treated) lesions.

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 3 Participant complete clearance of subclinical lesions.
Figuras y tablas -
Analysis 64.3

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 3 Participant complete clearance of subclinical lesions.

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 4 Mean percentage of reduction in all lesion counts.
Figuras y tablas -
Analysis 64.4

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 4 Mean percentage of reduction in all lesion counts.

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 5 Mean percentage of reduction in target (cryotherapy treated) lesion counts.
Figuras y tablas -
Analysis 64.5

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 5 Mean percentage of reduction in target (cryotherapy treated) lesion counts.

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 6 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 64.6

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 6 Withdrawal due to adverse events.

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 7 Skin irritation.
Figuras y tablas -
Analysis 64.7

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 7 Skin irritation.

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 8 Minor adverse events excluding skin irritation: body as a whole: fatigue.
Figuras y tablas -
Analysis 64.8

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 8 Minor adverse events excluding skin irritation: body as a whole: fatigue.

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 9 Minor adverse events excluding skin irritation: digestive: nausea.
Figuras y tablas -
Analysis 64.9

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 9 Minor adverse events excluding skin irritation: digestive: nausea.

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 10 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: myalgia.
Figuras y tablas -
Analysis 64.10

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 10 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: myalgia.

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 11 Minor adverse events excluding skin irritation: respiratory: upper respiratory tract infection.
Figuras y tablas -
Analysis 64.11

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 11 Minor adverse events excluding skin irritation: respiratory: upper respiratory tract infection.

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 12 Minor adverse events excluding skin irritation: respiratory: bronchitis.
Figuras y tablas -
Analysis 64.12

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 12 Minor adverse events excluding skin irritation: respiratory: bronchitis.

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 13 Minor adverse events excluding skin irritation: respiratory: sinusitis.
Figuras y tablas -
Analysis 64.13

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 13 Minor adverse events excluding skin irritation: respiratory: sinusitis.

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 14 Minor adverse events excluding skin irritation: special senses: conjunctivitis.
Figuras y tablas -
Analysis 64.14

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 14 Minor adverse events excluding skin irritation: special senses: conjunctivitis.

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 15 Cosmetic outcomes: Improved global photoageing score.
Figuras y tablas -
Analysis 64.15

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 15 Cosmetic outcomes: Improved global photoageing score.

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 16 Cosmetic outcomes: Improved fine lines.
Figuras y tablas -
Analysis 64.16

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 16 Cosmetic outcomes: Improved fine lines.

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 17 Cosmetic outcomes: Improved tactile roughness.
Figuras y tablas -
Analysis 64.17

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 17 Cosmetic outcomes: Improved tactile roughness.

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 18 Cosmetic outcomes: Improved mottled pigmentation.
Figuras y tablas -
Analysis 64.18

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 18 Cosmetic outcomes: Improved mottled pigmentation.

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 19 Cosmetic outcomes: Improved sallowness.
Figuras y tablas -
Analysis 64.19

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 19 Cosmetic outcomes: Improved sallowness.

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 20 Cosmetic outcomes: cosmetic appearance score.
Figuras y tablas -
Analysis 64.20

Comparison 64 Cryotherapy with vehicle versus cryotherapy with imiquimod, Outcome 20 Cosmetic outcomes: cosmetic appearance score.

Comparison 65 Cryotherapy with imiquimod versus cryotherapy with vehicle, Outcome 1 Participant complete clearance of all lesions.
Figuras y tablas -
Analysis 65.1

Comparison 65 Cryotherapy with imiquimod versus cryotherapy with vehicle, Outcome 1 Participant complete clearance of all lesions.

Comparison 65 Cryotherapy with imiquimod versus cryotherapy with vehicle, Outcome 2 Mean percentage of reduction in all lesion counts.
Figuras y tablas -
Analysis 65.2

Comparison 65 Cryotherapy with imiquimod versus cryotherapy with vehicle, Outcome 2 Mean percentage of reduction in all lesion counts.

Comparison 65 Cryotherapy with imiquimod versus cryotherapy with vehicle, Outcome 3 Withdrawal due to adverse events.
Figuras y tablas -
Analysis 65.3

Comparison 65 Cryotherapy with imiquimod versus cryotherapy with vehicle, Outcome 3 Withdrawal due to adverse events.

Comparison 65 Cryotherapy with imiquimod versus cryotherapy with vehicle, Outcome 4 Skin irritation.
Figuras y tablas -
Analysis 65.4

Comparison 65 Cryotherapy with imiquimod versus cryotherapy with vehicle, Outcome 4 Skin irritation.

Study

Intervention

Patient

Investigator

Van der Geer 2009

Diclofenac in 2.5% hyaluronic acid + ALA‐PDT

3.3

3.4

Van der Geer 2009

2.5% hyaluronic acid + ALA‐PDT

2.4

2.7

Figuras y tablas -
Analysis 66.1

Comparison 66 (3% diclofenac in 2.5% hyaluronic acid + ALA‐red light PDT) versus (2.5% hyaluronic acid + ALA‐red light PDT), Outcome 1 Global Improvement Indices (‐2 to 4) at 6 months.

Study

Intervention

At 6 weeks

At 6 months

At 12 months

Van der Geer 2009

Diclofenac in 2.5% hyaluronic acid + ALA‐PDT

10.13

11.56

12.5

Van der Geer 2009

2.5% hyaluronic acid + ALA‐PDT

9.9

10.56

8.8

Figuras y tablas -
Analysis 66.2

Comparison 66 (3% diclofenac in 2.5% hyaluronic acid + ALA‐red light PDT) versus (2.5% hyaluronic acid + ALA‐red light PDT), Outcome 2 Mean reduction of lesion counts.

Table 1. Overview for 3% diclofenac in 2.5% hyaluronic acid

Diclofenac in 2.5% hyaluronic acid compared to interventions for actinic keratoses in immunocompetent participants

Intervention/Comparison intervention

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

With comparator

Corresponding risk

With intervention

Participant complete clearance

3% diclofenac in 2.5% hyaluronic acid/2.5% hyaluronic acid

Study population

RR 2.46
(1.66 to 3.66)

420
(3 studies)

⊕⊕⊕⊝
moderate

For all lesions, data from 30, 60, and 90 day treatments pooled together, assessment at 30 days after the end of treatment (Analysis 6.5)

127 per 1000

313 per 1000
(211 to 466)

Moderate

132 per 1000

325 per 1000
(219 to 483)

3% diclofenac in 2.5% hyaluronic acid/5% imiquimod

Not reported

3% diclofenac in 2.5% hyaluronic acid + ALA‐red light PDT/2.5% hyaluronic acid + ALA‐red light PDT

Not reported

Mean reduction in lesion counts

3% diclofenac in 2.5% hyaluronic acid/2.5% hyaluronic acid

The mean reduction in lesion counts in the control groups was
2.5 lesions

The mean reduction of lesion counts in the intervention groups was
2.55 higher
(1.56 to 3.53 higher)

345
(2 studies)

⊕⊕⊕⊕
high

Data from 30, 60, and 90 day treatments pooled together, assessment 30 days after the end of treatment (Analysis 6.12)

3% diclofenac in 2.5% hyaluronic acid/ 5% imiquimod

Not reported

3% diclofenac in 2.5% hyaluronic acid + ALA‐red light PDT/2.5% hyaluronic acid + ALA‐red light PDT

See comment

See comment

Not estimable

10
(1 study)

⊕⊕⊝⊝
low

Intraindividual study: at 6 weeks; diclofenac/hyaluronic acid (HA) +  ALA‐PDT = 10.13, HA + ALA‐PDT= 9.9, at 6 months; diclofenac/HA + ALA‐PDT = 11.56, HA + ALA‐PDT = 10.56, at 12 months; diclofenac/HA + ALA‐PDT = 12.5, HA + ALA‐PDT = 8.8

Mean percentage of reduction in lesion counts

All comparisons

Not reported

Withdrawal due to adverse events

3% diclofenac in 2.5% hyaluronic acid/2.5% hyaluronic acid

Study population

RR 3.59
(1.92 to 6.7)

592
(4 studies)

⊕⊕⊕⊕
high

(Analysis 6.13)

Additional data from intraindividual study: no participant withdrew because of adverse events (N = 20). GRADE = low.

40 per 1000

144 per 1000
(77 to 269)

Moderate

43 per 1000

154 per 1000
(83 to 288)

3% diclofenac in 2.5% hyaluronic acid/5% imiquimod

0 per 1000

0 per 1000

Not estimable

49
(1 study)

⊕⊕⊕⊝
moderate

There were no participant withdrawals due to adverse events.

3% diclofenac in 2.5% hyaluronic acid + ALA‐red light PDT/2.5% hyaluronic acid + ALA‐red light PDT

0 per 1000

0 per 1000

Not estimable

10
(1 study)

⊕⊕⊕⊝
moderate

There were no participant withdrawals due to adverse events.

Skin irritation

3% diclofenac in 2.5% hyaluronic acid/2.5% hyaluronic acid

See comment

See comment

Not estimable

20
(1 study)

⊕⊕⊝⊝
low

Intraindividual study reported irritation only on the diclofenac treated side of 8 out of  20 participants

3% diclofenac in 2.5% hyaluronic acid/5% imiquimod

Not reported

3% diclofenac in 2.5% hyaluronic acid + ALA‐red light PDT/2.5% hyaluronic acid + ALA‐red light PDT

 ‐

Not reported

Figuras y tablas -
Table 1. Overview for 3% diclofenac in 2.5% hyaluronic acid
Table 2. Overview for 5‐fluorouracil

5‐fluorouracil (5‐FU) compared to interventions for actinic keratoses in immunocompetent participants

Intervention/Comparison intervention

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

With comparator

Corresponding risk

With intervention

Participant complete clearance

0.5% 5‐FU/Vehicle

Study population

RR 8.86
(3.67 to 21.40)

522
(3 studies)

⊕⊕⊕⊕
high

Data from 1, 2, and 4 week treatments were pooled together (Analysis 9.1)

15 per 1000

136 per 1000
(56 to 328)

Moderate

0 per 1000

0 per 1000
(0 to 0)

0.5% 5‐FU with cryotherapy/Vehicle with cryotherapy

71 per 1000

291 per 1000
(116 to 731)

RR 4.08
(1.63 to 10.23)

142
(1 study)

⊕⊕⊝⊝
low

1 cycle (Analysis 62.1)

0.5% 5‐FU/ALA‐PDT

292 per 1000

499 per 1000
(239 to 1000)

RR 1.71
(0.74 to 3.98)

48
(1 study)

⊕⊝⊝⊝
very low

Data from blue light and pulsed dye laser were pooled

(Analysis 11.1)

0.5% 5‐FU/5.0% 5‐FU

See comment

See comment

Not estimable

21
(1 study)

⊕⊝⊝⊝
very low

Intraindividual study: 0.5% and 5.0% 5‐FU = 9/21

5% 5‐FU with 0.05% tretinoin /5% 5‐FU with placebo

Not reported

5% 5‐FU /10% masoprocol

Not reported

5% 5‐FU/5% Imiquimod

Study population

RR 1.85
(0.41 to 8.33)

89
(2 studies)

⊕⊝⊝⊝
very low

(Analysis 13.1)

600 per 1000

1000 per 1000
(246 to 1000)

Moderate

555 per 1000

1000 per 1000
(230 to 1000)

5% 5‐FU/Carbon dioxide laser resurfacing

Not reported

5% 5‐FU/Er:YAG laser resurfacing

Not reported

5% 5‐FU/Cryotherapy

680 per 1000

959 per 1000
(721 to 1000)

RR 1.41
(1.06 to 1.87)

49
(1 study)

⊕⊕⊝⊝
low

Only data after the treatment

(Analysis 14.1)

5% 5‐FU/Trichloroacetic acid peel

Not reported

Mean reduction in lesion counts

0.5% 5‐FU/Vehicle

The mean reduction in lesion counts in the control groups was
4 lesions

The mean reduction in lesion counts in the intervention groups was
5.40 higher
(2.94 to 7.86 higher)

142
(1 study)

⊕⊕⊕⊝
moderate

Data from 1, 2, and 4 week treatment were pooled. (Analysis 9.2) Results from another study (N = 177) with no SD: placebo: 2.7 lesions, 5‐FU = 8.8 lesions, GRADE = moderate

0.5% 5‐FU with cryotherapy/Vehicle with cryotherapy

The mean reduction in lesion counts in the control groups was
6.6 lesions

The mean reduction in lesion counts in the intervention groups was
2 higher
(0.49 lower to 4.49 higher)

142
(1 study)

⊕⊕⊕⊝
moderate

1 cycle (Analysis 62.2)

0.5% 5‐FU/ALA‐PDT

Not reported

0.5% 5‐FU/5.0% 5‐FU

See comment

See comment

Not estimable

21
(1 study)

⊕⊕⊝⊝
low

Intraindividual study: results with no SD: 0.5% 5‐FU = 8.8 lesions, 5.0% 5‐FU = 6.1 lesions

5% 5‐FU with 0.05% tretinoin /5% 5‐FU with placebo

The mean reduction in lesion counts in the control groups was
11.1 lesions

The mean reduction in lesion counts in the intervention groups was
1.2 higher
(3.24 lower to 5.64 higher)

19
(1 study)

⊕⊕⊝⊝
low

(Analysis 12.1)

5% 5‐FU /10% masoprocol

The mean reduction in lesion counts in the control groups was
11.3 lesions

The mean reduction in lesion counts in the intervention groups was
1.5 higher
(2.36 lower to 5.36 higher)

49
(1 study)

⊕⊕⊝⊝
low

(Analysis 15.2)

5% 5‐FU/5% Imiquimod

Not reported

5% 5‐FU/Carbon dioxide laser resurfacing

Not reported

5% 5‐FU/Er:YAG laser resurfacing

See comment

See comment

Not estimable

55
(1 study)

⊕⊕⊝⊝
low

Results with no SD: number of lesions at 3 months:5‐FU = 13.2, resurfacing = 13.8, at 6 months:5‐FU = 12.5, resurfacing = 13.9, at 12 months: 5‐FU = 12.4, resurfacing = 14.2

5% 5‐FU/Cryotherapy

Not reported

5% 5‐FU/Trichloroacetic acid peel

Not reported

Mean percentage of reduction in lesion counts

0.5% 5‐FU/Vehicle

The mean percentage of reduction in lesion counts ranged across control groups from
28.8 per cent

The mean percentage of reduction in lesion counts in the intervention groups was
33.60 higher
(22.88 to 44.32 higher)

142
(1 study)

⊕⊕⊕⊝
moderate

Data from 1 week treatment.(Analysis 9.3) Results from two other studies with no SD

1) (N = 207) placebo = 21.6%, 5‐FU = 69.5%, GRADE = low,

2)(N = 177) placebo = 34.4%, 5‐FU = 78.5%, GRADE = moderate

0.5% 5‐FU with cryotherapy/Vehicle with cryotherapy

The mean percentage of reduction in lesion counts in the control groups was
45.6 per cent

The mean percentage of reduction in lesion counts in the intervention groups was
21.4 higher
(5.1 to 37.7 higher)

142
(1 study)

⊕⊕⊕⊝
moderate

(Analysis 62.3)

0.5% 5‐FU/ALA‐PDT

Not reported

0.5% 5‐FU/5.0% 5‐FU

See comment

See comment

Not estimable

21
(1 study)

⊕⊕⊝⊝
low

Intraindividual study: results with no SD: 0.5% 5‐FU = 67% and 5.0% 5‐FU = 47%

5% 5‐FU with 0.05% tretinoin /5% 5‐FU with placebo

Not reported

5% 5‐FU /10% masoprocol

The mean percentage of reduction in lesion counts in the control groups was
77.6 percent

The mean percentage of reduction in lesion counts in the intervention groups was
20 higher
(11.82 to 28.18 higher)

49
(1 study)

⊕⊕⊕⊝
moderate

(Analysis 15.3)

5% 5‐FU/5% Imiquimod

See comment

See comment

Not estimable

39
(1 study)

⊕⊕⊝⊝
low

Results with no SD: 5% 5‐FU = 94%, 5% imiquimod = 66%

5% 5‐FU/Carbon dioxide laser resurfacing

The mean percentage of reduction in lesion counts in the control groups was
92 percent

The mean percentage of reduction in lesion counts in the intervention groups was
8.80 lower
(20.76 lower to 3.16 higher)

14
(1 study)

⊕⊝⊝⊝
very low

(Analysis 16.1 )

5% 5‐FU/Er:YAG laser resurfacing

See comment

See comment

Not estimable

55
(1 study)

⊕⊕⊝⊝
low

Results with no SD: at 6 months: 5‐FU = 79.2%, resurfacing 94.5%, at 12 months: 5‐FU = 76.6%, resurfacing = 91.1%

5% 5‐FU/Cryotherapy

Not reported

5% 5‐FU/Trichloroacetic acid peel

The mean percentage of reduction in lesion counts in the control groups was
89 per cent

The mean percentage of reduction in lesion counts in the intervention groups was
5.8 lower
(15.38 lower to 3.78 higher)

18
(1 study)

⊕⊝⊝⊝
very low

(Analysis 18.1)

Withdrawal due to adverse events

0.5% 5‐FU/Vehicle

0 per 1000

N/A (5/119 = 42/1000)

RR 5.41
(0.3 to 96.18)

177
(1 study)

⊕⊝⊝⊝
very low

Data from 1, 2, and 4 week treatments were pooled.(Analysis 9.4) Another study reported 24/207 participants withdrew because of adverse events and 12 of them were in 4 week 5‐FU group. GRADE = low

0.5% 5‐FU with cryotherapy/Vehicle with cryotherapy

See comment

See comment

Not estimable

142
(1 study)

⊕⊕⊝⊝
low

There were no participant withdrawals in the first part of this three part study (incomplete data were given for the whole study).

0.5% 5‐FU/ALA‐PDT

0 per 1000

N/A (1/12 = 83/1000)

RR 5.77
(0.25 to 131.92)

36
(1 study)

⊕⊕⊝⊝
low

Data from blue light and pulsed dye laser were pooled

(Analysis 11.2)

0.5% 5‐FU/5.0% 5‐FU

See comment

See comment

Not estimable

21
(1 study)

⊕⊕⊝⊝
low

Intraindividual study: 16/21 discontinued treatment but did not withdraw: 4 because of 0.5%, 8 because of 5.0% , 4 because of both creams.

5% 5‐FU with 0.05% tretinoin /5% 5‐FU with placebo

See comment

See comment

Not estimable

19
(1 study)

⊕⊕⊝⊝
low

Intraindividual study: 1 participant withdrew because of irritation but associated treatment was not specified.

5% 5‐FU /10% masoprocol

0 per 1000

N/A (1/30 = 33/1000)

RR 2.71
(0.12 to 63.84)

57
(1 study)

⊕⊕⊝⊝
low

(Analysis 15.4)

5% 5‐FU/5% Imiquimod

0 per 1000

0 per 1000

Not estimable

89
(2 studies)

⊕⊕⊝⊝
low

There were no participant withdrawals due to adverse events.

5% 5‐FU/Carbon dioxide laser resurfacing

250 per 1000

45 per 1000
(2 to 817)

RR 0.18
(0.01 to 3.27)

17
(1 study)

⊕⊕⊝⊝
low

(Analysis 16.2)

5% 5‐FU/Er:YAG laser resurfacing

0 per 1000

N/A (1/27 = 37/1000)

RR 3.11
(0.13 to 73.11)

55
(1 study)

⊕⊕⊝⊝
low

(Analysis 17.1)

5% 5‐FU/Cryotherapy

0 per 1000

0 per 1000

Not estimable

49
(1 study)

⊕⊕⊕⊝
moderate

There were no participant withdrawals due to adverse events.

5% 5‐FU/Trichloroacetic acid peel

0 per 1000

0 per 1000

Not estimable

18
(1 study)

⊕⊕⊝⊝
low

There were no participant withdrawals due to adverse events.

Skin irritation

0.5% 5‐FU/Vehicle

654 per 1000

948 per 1000
(830 to 1000)

RR 1.45
(1.27 to 1.65)

384
(2 studies)

⊕⊕⊕⊝
moderate

Data from 1, 2, and 4 week treatments were pooled

(Analysis 9.5)

0.5% 5‐FU with cryotherapy/Vehicle with cryotherapy

Not reported

0.5% 5‐FU/ALA‐PDT

Not reported

0.5% 5‐FU/5.0% 5‐FU

1000 per 1000

1000 per 1000

21
(1 study)

⊕⊕⊕⊝
moderate

Intraindividual study: All participants reported facial irritation in association with both creams

5% 5‐FU with 0.05% tretinoin /5% 5‐FU with placebo

See comment

See comment

Not estimable

19
(1 study)

⊕⊕⊕⊝
moderate

Intraindividual study: 12 had more irritation with tretinoin, 4 had more with placebo, and 3 had equal irritation.

5% 5‐FU /10% masoprocol

Not reported

5% 5‐FU/5% Imiquimod

Not reported

5% 5‐FU/Carbon dioxide laser resurfacing

Not reported

5% 5‐FU/Er:YAG laser resurfacing

429 per 1000

703 per 1000
(429 to 1000)

RR 1.64
(1 to 2.69)

55
(1 study)

⊕⊕⊝⊝
low

At the end of treatment

(Analysis 17.2)

5% 5‐FU/Cryotherapy

Not reported

5% 5‐FU/Trichloroacetic acid peel

Not reported

Figuras y tablas -
Table 2. Overview for 5‐fluorouracil
Table 3. Overview for photodynamic therapy

Photodynamic therapy compared to interventions for actinic keratoses in immunocompetent participants

Intervention/Comparison intervention

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

With comparator

Corresponding risk

With intervention

Participant complete clearance

ALA‐PDT

1h ALA‐blue light PDT /1h ALA‐pulsed dye laser PDT

(field‐directedtreatments)

83 per 1000

500 per 1000
(71 to 1000)

RR 6
(0.85 to 42.59)

24
(1 study)

⊕⊝⊝⊝
very low

(Analysis 48.1)

1h ALA‐blue light PDT /0.5% 5‐FU

(field‐directedtreatments)

500 per 1000

500 per 1000 (225 to 1000)

RR 1
(0.45 to 2.23)

24
(1 study)

⊕⊝⊝⊝
very low

(Analysis 50.1)

14‐18h ALA‐blue light PDT /14‐18h placebo‐blue light PDT

(individual lesions)

97  per 1000

602 per 1000
(279 to 1000)

RR 6.22
(2.88 to 13.43)

243
(1 study)

⊕⊝⊝⊝
very low

1 treatment.

(Analysis 47.1) Additional intraindividual study: ALA‐PDT: 16/35, placebo‐PDT = 2/35. GRADE = moderate

1h ALA‐pulsed dye laser PDT /0.5% 5‐FU

(field‐directedtreatments)

500 per 1000

85 per 1000
(10 to 590)

RR 0.17
(0.02 to 1.18)

24
(1 study)

⊕⊝⊝⊝
very low

(Analysis 50.1)

0.5h ALA‐red light PDT/1h ALA‐red light PDT (individual lesions)

474 per 1000

237 per 1000
(118 to 469)

RR 0.5
(0.25 to 0.99)

72
(1 study)

⊕⊕⊝⊝
low

Data from assessment at 8 weeks after the end of treatment (Analysis 49.2)

0.5h ALA‐red light PDT/2h ALA‐red light PDT

(individual lesions)

471 per 1000

235 per 1000
(118 to 475)

RR 0.5
(0.25 to 1.01)

68
(1 study)

⊕⊝⊝⊝
very low

Data from assessment at 8 weeks after the end of treatment

(Analysis 49.2)

0.5h ALA‐red light PDT /4h ALA‐red light PDT (individual lesions)

735 per 1000

235 per 1000
(125 to 449)

RR 0.32
(0.17 to 0.61)

68
(1 study)

⊕⊕⊝⊝
low

Data from assessment at 8 weeks after the end of treatment

(Analysis 49.2)

1h ALA‐red light PDT /2h ALA‐red light PDT (individual lesions)

471 per 1000

475 per 1000
(292 to 772)

RR 1.01
(0.62 to 1.64)

72
(1 study)

⊕⊝⊝⊝
very low

Data from assessment at 8 weeks after the end of treatment

(Analysis 49.2)

1h ALA‐red light PDT /4h ALA‐red light PDT (individual lesions)

735 per 1000

471 per 1000
(324 to 699)

RR 0.64
(0.44 to 0.95)

72
(1 study)

⊕⊕⊝⊝
low

Data from assessment at 8 weeks after the end of treatment

(Analysis 49.2)

2h ALA‐red light PDT/4h ALA‐red light PDT (individual lesions)

735 per 1000

471 per 1000
(309 to 706)

RR 0.64
(0.42 to 0.96)

68
(1 study)

⊕⊕⊝⊝
low

Data from assessment at 8 weeks after the end of treatment (Analysis 49.2)

3‐4h ALA‐red light PDT/3 to 4h placebo‐red light PDT

(individual lesions)

89 per 1000

527 per 1000
(297 to 935)

RR 5.94
(3.35 to 10.54)

422
(3 studies)

⊕⊕⊕⊕
high

1 treatment (Analysis 47.1)

3% diclofenac in 2.5% hyaluronan gel + 4h ALA‐red light PDT /2.5% hyaluronan gel + 4h ALA‐red light PDT

(field‐directedtreatments)

Not reported

4h ALA‐red light PDT/Cryotherapy

(individual lesions)

443 per 1000

580 per 1000
(465 to 726)

RR 1.31
(1.05 to 1.64)

297
(1 study)

⊕⊕⊝⊝
low

(Analysis 51.1)

ALA‐red light PDT (individual lesions)/5% imiquimod (field‐directedtreatment)

Not reported

ALA‐blue light PDT + 5% imiquimod / ALA‐blue light PDT + placebo

(field‐directedtreatments)

See comment

See comment

Not estimable

25
(1 study)

⊕⊕⊝⊝
low

Intraindividual study: ALA‐PDT + 5% imiquimod = 2/25; ALA‐PDT + placebo = 2/25

ALA‐PDT versus MAL‐PDT

5h ALA‐red light PDT /3h MAL‐red light PDT

(field‐directedtreatments)

See comment

See comment

Not estimable

16
(1 study)

⊕⊕⊕⊝
moderate

Intraindividual study: ALA‐PDT = 6/16, MAL‐PDT = 7/16

MAL‐PDT

All day 16% MAL‐daylight PDT /All day 8% MAL‐daylight PDT

(field‐directedtreatments)

Not reported

2h MAL‐daylight PDT /3h MAL‐daylight PDT

(field‐directedtreatments)

Not reported

2.5‐4h MAL‐red light PDT /2.5‐4h placebo‐red light PDT

(individual lesions)

147 per 1000

656 per 1000
(466 to 924)

RR 4.46
(3.17 to 6.28)

482
(5 studies)

⊕⊕⊕⊝
moderate

(Analysis 52.1)

3h MAL‐red light LED PDT /3h MAL‐broad visible + water‐filtered infrared A PDT

(individual lesions)

500 per 1000

575 per 1000
(380 to 865)

RR 1.15
(0.76 to 1.73)

80
(1 study)

⊕⊕⊝⊝
low

Data from assessment at 12 weeks after the end of treatment.(Analysis 53.1)

3h MAL‐red light LED PDT /3h MAL‐daylight PDT

(field‐directedtreatments)

Not reported

Single 3h MAL‐red light PDT /Multiple 3h MAL‐red light PDT [2 treatments 1 week apart]

(individual lesions)

755 per 1000

883 per 1000
(777 to 1000)

RR 1.17
(1.03 to 1.33)

211
(1 study)

⊕⊕⊝⊝
low

(Analysis 57.1)

3h MAL‐red light PDT /Cryotherapy

(individual lesions)

Not reported

Mean reduction in lesion counts

ALA‐PDT

1h ALA‐blue light PDT /1h ALA‐pulsed dye laser PDT

(field‐directedtreatments)

Not reported

1h ALA‐blue light PDT /0.5% 5‐FU

(field‐directedtreatments)

Not reported

14‐18h ALA‐blue light PDT /14‐18h placebo‐blue light PDT

(individual lesions)

Not reported

1h ALA‐pulsed dye laser PDT /0.5% 5‐FU

(field‐directedtreatments)

Not reported

0.5h ALA‐red light PDT/1h ALA‐red light PDT (individual lesions)

Not reported

0.5h ALA‐red light PDT/2h ALA‐red light PDT

(individual lesions)

Not reported

0.5h ALA‐red light PDT /4h ALA‐red light PDT (individual lesions)

Not reported

1h ALA‐red light PDT /2h ALA‐red light PDT (individual lesions)

Not reported

1h ALA‐red light PDT /4h ALA‐red light PDT (individual lesions)

Not reported

2h ALA‐red light PDT /4h ALA‐red light PDT (individual lesions)

Not reported

3‐4h ALA‐red light PDT /3‐4h placebo‐red light PDT

(individual lesions)

Not reported

3% diclofenac in 2.5% hyaluronic acid gel + 4h ALA‐red light PDT /2.5% hyaluronic acid gel + 4h ALA‐red light PDT

(field‐directedtreatments)

See comment

See comment

Not estimable

10
(1 study)

⊕⊕⊝⊝
low

Intraindividual study: at 6 weeks; diclofenac/hyaluronic acid (HA) +  ALA‐PDT = 10.13, HA + ALA‐PDT= 9.9, at 6 months:;  diclofenac/HA + ALA‐PDT = 11.56, HA + ALA‐PDT = 10.56, at 12 months;  diclofenac/HA + ALA‐PDT = 12.5, HA + ALA‐PDT = 8.8

4h ALA‐red light PDT /Cryotherapy

(individual lesions)

Not reported

ALA‐red light PDT (individual lesions)/5% imiquimod (field‐directedtreatment)

Not reported

ALA‐blue light PDT + 5% imiquimod / ALA‐blue light PDT + placebo

(field‐directedtreatments)

See comment

See comment

Not estimable

25
(1 study)

⊕⊕⊝⊝
low

Results from intraindividual study without SD: ALA‐PDT + 5% imiquimod = 19.9 lesions; ALA‐PDT + placebo = 16.0 lesions

ALA‐PDT versus MAL‐PDT        

5h ALA‐red light PDT /3h MAL‐red light PDT

(field‐directedtreatments)

The mean reduction in lesion counts in the control groups was
5.6 lesions

The mean reduction in lesion counts in the intervention groups was 0.6 higher
(1.28 lower to 2.48 higher)

15
(1 study)

⊕⊕⊝⊝
low

(Analysis 59.1)

MAL‐PDT

All day 16% MAL‐daylight PDT /All day 8% MAL‐daylight PDT

(field‐directedtreatments)

The mean reduction in lesion counts in the control groups was
14.5 lesions

The mean reduction in lesion counts in the intervention groups was 0.3 higher
(3.77 lower to 4.37 higher)

29
(1 study)

⊕⊕⊝⊝
low

(Analysis 56.1)

2h MAL‐daylight PDT /3h MAL‐daylight PDT

(field‐directedtreatments)

The mean reduction in lesion counts in the control groups was
9.7 lesions

The mean reduction in lesion counts in the intervention groups was 0.1 higher
(3.17 lower to 3.37 higher)

120
(1 study)

⊕⊕⊝⊝
low

(Analysis 55.1)

2.5‐4h MAL‐red light PDT /2.5‐4h placebo‐red light PDT

(individual lesions)

Not reported

3h MAL‐red light LED PDT /3h MAL‐broad visible + water‐filtered infrared A PDT

(individual lesions)

Not reported

3h MAL‐red light LED PDT /3h MAL‐daylight PDT

(field‐directedtreatments)

The mean reduction in lesion counts in the control groups was
8.4 lesions

The mean reduction in lesion counts in the intervention groups was 0.4 lower
(3.23 lower to 2.43 higher)

29
(1 study)

⊕⊕⊝⊝
low

(Analysis 54.1)

Single 3h MAL‐red light PDT /Multiple 3h MAL‐red light PDT [2 treatments 1 week apart]

(individual lesions)

Not reported

3h MAL‐red light PDT /Cryotherapy

(individual lesions)

Not reported

Mean percentage of reduction in lesion count

ALA‐PDT

1h ALA‐blue light PDT /1h ALA‐pulsed dye laser PDT

(field‐directedtreatments)

Not reported

1h ALA‐blue light PDT /0.5% 5‐FU

(field‐directedtreatments)

Not reported

14‐18h ALA‐blue light PDT /14‐18h placebo‐blue light PDT

(individual lesions)

Not reported

1h ALA‐pulsed dye laser PDT /0.5% 5‐FU

(field‐directedtreatments)

Not reported

0.5h ALA‐red light PDT/1h ALA‐red light PDT (individual lesions)

Not reported

0.5h ALA‐red light PDT/2h ALA‐red light PDT

(individual lesions)

Not reported

0.5h ALA‐red light PDT /4h ALA‐red light PDT (individual lesions)

Not reported

1h ALA‐red light PDT /2h ALA‐red light PDT (individual lesions)

Not reported

1h ALA‐red light PDT /4h ALA‐red light PDT (individual lesions)

Not reported

2h ALA‐red light PDT /4h ALA‐red light PDT (individual lesions)

Not reported

3‐4h ALA‐red light PDT /3‐4h placebo‐red light PDT

(individual lesions)

Not reported

3% diclofenac in 2.5% hyaluronic acid gel + 4h ALA‐red light PDT /2.5% hyaluronic acid gel + 4h ALA‐red light PDT

(field‐directedtreatments)

Not reported

4h ALA‐red light PDT /Cryotherapy

(individual lesions)

Not reported

ALA‐red light PDT (individual lesions)/5% imiquimod (field‐directedtreatment)

Not reported

ALA‐blue light PDT + 5% imiquimod / ALA‐blue light PDT + placebo

(field‐directedtreatments)

See comment

See comment

Not estimable

25
(1 study)

⊕⊕⊝⊝
low

Results from intraindividual study without SD: ALA‐PDT + 5% imiquimod = 86.7%; ALA‐PDT + placebo = 73.1%

ALA‐PDT versus MAL‐PDT

5h ALA‐red light PDT /3h MAL‐red light PDT

(field‐directedtreatments)

See comment

Not reported

MAL‐PDT

All day 16% MAL‐daylight PDT /All day 8% MAL‐daylight PDT

(field‐directedtreatments)

See comment

See comment

Not estimable

29
(1 study)

⊕⊕⊝⊝
low

Data with no SD:

16% MAL‐daylight PDT = 76.9%, 8% MAL‐daylight PDT = 79.5%.

2h MAL‐daylight PDT /3h MAL‐daylight PDT

(field‐directedtreatments)

The mean percentage of reduction in lesion counts in the control groups was
74.6 percent

The mean percentage of reduction in lesion counts in the intervention groups was 2.6 higher
(6.46 lower to 11.66 higher)

120
(1 study)

⊕⊕⊝⊝
low

(Analysis 55.2)

2.5‐4h MAL‐red light PDT /2.5‐4h placebo‐red light PDT

(individual lesions)

Not reported

3h MAL‐red light LED PDT /3h MAL‐broad visible + water‐filtered infrared A PDT

(individual lesions)

Not reported

3h MAL‐red light LED PDT /3h MAL‐daylight PDT

(field‐directedtreatments)

See comment

See comment

Not estimable

29
(1 study)

⊕⊕⊝⊝
low

Data with no SD: MAL‐red light LED PDT = 71%, MAL‐daylight PDT = 79%.

Single 3h MAL‐red light PDT /Multiple 3h MAL‐red light PDT [2 treatments 1 week apart]

(individual lesions)

Not reported

3h MAL‐red light PDT /Cryotherapy

(individual lesions)

See comment

See comment

Not estimable

240
(2 studies)

⊕⊝⊝⊝
very low

Intraindividual studies with no SD: at 12 weeks: MAL‐PDT = 84.4%, cryotherapy = 74.5%, at 24 weeks: MAL‐PDT = 75‐86.7%, cryotherapy = 83.9‐87%

Withdrawal due to adverse events

ALA‐PDT

1h ALA‐blue light PDT /1h ALA‐pulsed dye laser PDT

(field‐directedtreatments)

0  per 1000

0  per 1000

Not estimable

24
(1 study)

⊕⊕⊝⊝
low

There were no participant withdrawals due to adverse events.

1h ALA‐blue light PDT /0.5% 5‐FU

(field‐directedtreatments)

83 per 1000

28 per 1000
(1 to 621)

RR 0.33
(0.01 to 7.45)

24
(1 study)

⊕⊕⊝⊝
low

(Analysis 50.3)

14‐18h ALA‐blue light PDT /14‐18h placebo‐blue light PDT

(individual lesions)

0  per 1000

0  per 1000

Not estimable

271
(2 studies)

⊕⊕⊝⊝
low

There were no participant withdrawals due to adverse events.

1h ALA‐pulsed dye laser PDT /0.5% 5‐FU

(field‐directedtreatments)

83 per 1000

28 per 1000
(1 to 621)

RR 0.33
(0.01 to 7.45)

24
(1 study)

⊕⊕⊝⊝
low

(Analysis 50.3)

0.5h ALA‐red light PDT/1h ALA‐red light PDT (individual lesions)

See comment

See comment

Not estimable

72
(1 study)

⊕⊝⊝⊝
very low

No details were given for the reasons for withdrawal.

0.5h ALA‐red light PDT/2h ALA‐red light PDT

(individual lesions)

See comment

See comment

Not estimable

68
(1 study)

⊕⊝⊝⊝
very low

No details were given for the reasons for withdrawal.

0.5h ALA‐red light PDT /4h ALA‐red light PDT (individual lesions)

See comment

See comment

Not estimable

68
(1 study)

⊕⊝⊝⊝
very low

No details were given for the reasons for withdrawal.

1h ALA‐red light PDT /2h ALA‐red light PDT (individual lesions)

See comment

See comment

Not estimable

72
(1 study)

⊕⊝⊝⊝
very low

No details were given for the reasons for withdrawal.

1h ALA‐red light PDT /4h ALA‐red light PDT (individual lesions)

See comment

See comment

Not estimable

72
(1 study)

⊕⊝⊝⊝
very low

No details were given for the reasons for withdrawal.

2h ALA‐red light PDT /4h ALA‐red light PDT (individual lesions)

See comment

See comment

Not estimable

68
(1 study)

⊕⊝⊝⊝
very low

No details were given for the reasons for withdrawal.

3‐4h ALA‐red light PDT /3‐4h placebo‐red light PDT

(individual lesions)

0  per 1000

0  per 1000

Not estimable

391
(3 studies)

⊕⊕⊕⊕
high

There were no participant withdrawals due to adverse events.

3% diclofenac in 2.5% hyaluronic acid gel + 4h ALA‐red light PDT /2.5% hyaluronic acid gel + 4h ALA‐red light PDT

(field‐directedtreatments)

0  per 1000

0  per 1000

Not estimable

10
(1 study)

⊕⊕⊕⊝
moderate

There were no participant withdrawals due to adverse events.

4h ALA‐red light PDT /Cryotherapy

(individual lesions)

0  per 1000

0  per 1000

Not estimable

255
(1 study)

⊕⊕⊕⊝
moderate

There were no participant withdrawals due to adverse events.

ALA‐red light PDT (individual lesions)/5% imiquimod (field‐directedtreatment)

0 per 1000

0 per 1000

Not estimable

30
(1 study)

⊕⊕⊝⊝
low

There were no participant withdrawals due to adverse events.

ALA‐blue light PDT + 5% imiquimod / ALA‐blue light PDT + placebo

(field‐directedtreatments)

0 per 1000

0 per 1000

Not estimable

25
(1 study)

⊕⊕⊝⊝
low

There were no participant withdrawals due to adverse events.

ALA‐PDT versus MAL‐PDT

5h ALA‐red light PDT /3h MAL‐red light PDT

(field‐directedtreatments)

0  per 1000

0  per 1000

Not estimable

15
(1 study)

⊕⊕⊕⊝
moderate

There were no participant withdrawals due to adverse events.

MAL‐PDT

All day 16% MAL‐daylight PDT /All day 8% MAL‐daylight PDT

(field‐directedtreatments)

See comment

See comment

Not estimable

29
(1 study)

⊕⊕⊕⊝
moderate

One of 30 participants withdrew because of adverse events unrelated to treatments.

2h MAL‐daylight PDT /3h MAL‐daylight PDT

(field‐directedtreatments)

0  per 1000

0  per 1000

Not estimable

120
(1 study)

⊕⊕⊕⊝
moderate

There were no participant withdrawals due to adverse events.

2.5‐4h MAL‐red light PDT /2.5‐4h placebo‐red light PDT

(individual lesions)

0 per 1000

N/A (3/130 = 23/1000)

RR 2
(0.23 to 17.74)

191
(2 studies)

⊕⊝⊝⊝
very low

(Analysis 52.3)

Two additional studies with no participant withdrawals because of adverse events (N = 211). GRADE = low

3h MAL‐red light LED PDT /3h MAL‐broad visible + water‐filtered infrared A PDT

(individual lesions)

0  per 1000

0  per 1000

Not estimable

78
(1 study)

⊕⊕⊕⊝
moderate

There were no participant withdrawals due to adverse events.

3h MAL‐red light LED PDT /3h MAL‐daylight PDT

(field‐directedtreatments)

0  per 1000

0  per 1000

Not estimable

29
(1 study)

⊕⊕⊕⊝
moderate

There were no participant withdrawals due to adverse events.

Single 3h MAL‐red light PDT /Multiple 3h MAL‐red light PDT [2 treatments 1 week apart]

(individual lesions)

9 per 1000

3 per 1000
(0 to 77)

RR 0.34
(0.01 to 8.17)

211
(1 study)

⊕⊕⊝⊝
low

(Analysis 57.2)

3h MAL‐red light PDT /Cryotherapy

(individual lesions)

11 per 1000

10 per 1000
(1 to 67)

RR 0.94
(0.14 to 6.36)

379
(2 studies)

⊕⊕⊕⊝
moderate

(Analysis 58.1)

Two additional intraindividual studies: 4 of 119 and 2 of 121 participants withdrew because of adverse events and one of them was related to MAL‐PDT. GRADE = low

Skin irritation

ALA‐PDT

1h ALA‐blue light PDT /1h ALA‐pulsed dye laser PDT

(field‐directedtreatments)

Not reported

1h ALA‐blue light PDT /0.5% 5‐FU

(field‐directedtreatments)

Not reported

14‐18h ALA‐blue light PDT /14‐18h placebo‐blue light PDT

(individual lesions)

Not reported

1h ALA‐pulsed dye laser PDT /0.5% 5‐FU

(field‐directedtreatments)

Not reported

0.5h ALA‐red light PDT/1h ALA‐red light PDT (individual lesions)

Not reported

0.5h ALA‐red light PDT/2h ALA‐red light PDT

(individual lesions)

Not reported

0.5h ALA‐red light PDT/4h ALA‐red light PDT (individual lesions)

Not reported

1h ALA‐red light PDT/2h ALA‐red light PDT (individual lesions)

Not reported

1h ALA‐red light PDT/4h ALA‐red light PDT (individual lesions)

Not reported

2h ALA‐red light PDT/4h ALA‐red light PDT (individual lesions)

Not reported

3 to 4h ALA‐red light PDT /3 to 4h placebo‐red light PDT

(individual lesions)

0 per 1000

N/A (77/217 = 355/1000)

RR 59.72
(3.75  to 952.48)

300
(2 studies)

⊕⊕⊕⊝
moderate

Data for ALA‐PDT was given separately for two studies but not for placebo. Data from assessment after treatment (Analysis 47.7)

3% diclofenac in 2.5% hyaluronic acid gel + 4h ALA‐red light PDT /2.5% hyaluronic acid gel + 4h ALA‐red light PDT

(field‐directedtreatments)

Not reported

4h ALA‐red light PDT /Cryotherapy

(individual lesions)

101 per 1000

371 per 1000
(220 to 627)

RR 3.69
(2.19 to 6.23)

297
(1 study)

⊕⊕⊝⊝
low

Assessment one day after the treatment (Analysis 51.2)

ALA‐red light PDT (individual lesions)/5% imiquimod (field‐directedtreatment)

Not reported

ALA‐blue light PDT + 5% imiquimod / ALA‐blue light PDT + placebo

(field‐directedtreatments)

Not reported

ALA‐PDT versus MAL‐PDT

5h ALA‐red light PDT /3h MAL‐red light PDT

(field‐directedtreatments)

Not reported

MAL‐PDT

All comparisons

Not reported

Figuras y tablas -
Table 3. Overview for photodynamic therapy
Table 4. Overview for cryotherapy

Cryotherapy compared to interventions for actinic keratoses in immunocompetent participants

Intervention/ Comparison intervention

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

With comparator

With intervention

Participant complete clearance

Cryotherapy /Betulin‐based oleogel

643 per 1000

784 per 1000
(489 to 1000)

RR 1.22
(0.76 to 1.97)

28
(1 study)

⊕⊝⊝⊝
very low

(Analysis 42.1)

Cryotherapy/cryotherapy with betulin‐based oleogel

714 per 1000

786 per 1000
(514 to 1000)

RR 1.1
(0.72 to 1.69)

28
(1 study)

⊕⊝⊝⊝
very low

(Analysis 61.1)

Cryotherapy/5% 5‐FU

958 per 1000

680 per 1000
(518 to 901)

RR 0.71
(0.54 to 0.94)

49
(1 study)

⊕⊕⊝⊝
low

Assessment after treatment (Analysis 43.1)

Vehicle with cryotherapy/0.5% 5‐FU with cryotherapy

292 per 1000

70 per 1000
(29 to 178)

RR 0.24
(0.1 to 0.61)

142
(1)

⊕⊕⊝⊝
low

1 cycle (Analysis 63.1)

Cryotherapy /Imiquimod

846 per 1000

677 per 1000
(499 to 931)

RR 0.8
(0.59 to 1.10)

51
(1 study)

⊕⊝⊝⊝
very low

5% imiquimod (Analysis 44.1)

Cryotherapy with vehicle /Cryotherapy with imiquimod

Study population

RR 0.2
(0.05 to 0.73)

311
(2 studies)

⊕⊕⊕⊕
high

Pooled data (5% and 3.75% imiquimod)(Analysis 64.1)

Results from an additional intraindividual study: cryotherapy + vehicle = 5/27, cryotherapy+imiquimod = 8/27 GRADE = moderate

287 per 1000

57 per 1000
(14 to 209)

Moderate

264 per 1000

53 per 1000
(13 to 193)

Cryotherapy /ALA‐red light PDT

581 per 1000

442 per 1000
(354 to 558)

RR 0.76
(0.61 to 0.96)

297
(1 study)

⊕⊕⊝⊝
low

(Analysis 46.1)

Cryotherapy/MAL‐red light PDT

Not reported

Mean reduction in lesion counts

Cryotherapy /Betulin‐based oleogel

Not reported

Cryotherapy/cryotherapy with betulin‐based oleogel

Not reported

Cryotherapy/5% 5‐FU

Not reported

Vehicle + cryotherapy/0.5% 5‐FU + cryotherapy

The mean reduction in lesion counts in the control groups was
8.6 lesions

The mean reduction in lesion counts in the intervention groups was
2 lower
(4.49 lower to 0.49 higher)

142
(1)

⊕⊕⊕⊝
moderate

1 cycle (Analysis 63.2)

Cryotherapy /Imiquimod

Not reported

Cryotherapy with vehicle /Cryotherapy with imiquimod

Not reported

Cryotherapy /ALA‐red light PDT

Not reported

Cryotherapy/MAL‐red light PDT

Not reported

Mean percentage of reduction in lesion counts

Cryotherapy /Betulin‐based oleogel

Not reported

Cryotherapy/cryotherapy with betulin‐based oleogel

Not reported

Cryotherapy/5% 5‐FU

Not reported

Vehicle with cryotherapy/0.5% 5‐FU with cryotherapy

The mean percentage of reduction in lesion counts in the control groups was
67 percent

The mean percentage of reduction in lesion counts in the intervention groups was
21.4 lower
(37.7 to 5.1 lower)

142
(1)

⊕⊕⊕⊝
moderate

(Analysis 63.3)

Cryotherapy /Imiquimod

Not reported

Cryotherapy with vehicle /Cryotherapy with imiquimod

See comment

See comment

301
(2 studies)

⊕⊝⊝⊝
very low

High heterogeneity (I2=86%) between 3.75% (parallel group, MD ‐34.10, 95% CI ‐41.38 to ‐26.82)) and 5.0% (intraindividual, MD ‐11.20, 95% CI ‐26.53 to 4.13) imiquimod studies. (Analysis 64.4)

Cryotherapy /ALA‐red light PDT

Not reported

Cryotherapy/MAL‐red light PDT

See comment

See comment

Not estimable

240
(2 studies)

⊕⊝⊝⊝
very low

Intraindividual studies with no SD: at 12 weeks: cryotherapy = 74.5%, MAL‐PDT= 84.4%, at 24 weeks: cryotherapy = 83.9‐87%, MAL‐PDT = 75‐86.7%

Withdrawal due to adverse events

Cryotherapy /Betulin‐based oleogel

0 per 1000

0 per 1000

Not estimable

28
(1 study)

⊕⊕⊕⊝
moderate

There were no participant withdrawals due to adverse events.

Cryotherapy/cryotherapy with betulin‐based oleogel

0 per 1000

0 per 1000

Not estimable

28
(1 study)

⊕⊕⊕⊝
moderate

There were no participant withdrawals due to adverse events.

Cryotherapy/5% 5‐FU

0 per 1000

0 per 1000

Not estimable

49
(1 study)

⊕⊕⊕⊝
moderate

There were no participant withdrawals due to adverse events.

Vehicle with cryotherapy/0.5% 5‐FU with cryotherapy

See comment

See comment

Not estimable

142
(1 study)

⊕⊕⊝⊝
low

There were no participant withdrawals due to adverse events in the first part of this three part study (incomplete data were given for the whole study).

Cryotherapy /Imiquimod

0 per 1000

0 per 1000

Not estimable

51
(1 study)

⊕⊕⊕⊝
moderate

There were no participant withdrawals due to adverse events.

Cryotherapy with vehicle /Cryotherapy with imiquimod

Study population

RR 0.93
(0.28 to 3.07)

312
(2 studies)

⊕⊕⊕⊝
moderate

Pooled data (5% and 3.75% imiquimod) (Analysis 64.6)

33 per 1000

30 per 1000
(9 to 100)

Moderate

21 per 1000

20 per 1000
(6 to 64)

Cryotherapy /ALA‐ red light PDT

0 per 1000

0 per 1000

Not estimable

297
(1 study)

⊕⊕⊕⊝
moderate

There were no participant withdrawals due to adverse events.

Cryotherapy/MAL‐ red light PDT

11 per 1000

11 per 1000
(2 to 75)

RR 1.06
(0.16 to 7.16)

379
(2 studies)

⊕⊕⊕⊝
moderate

(Analysis 45.2)

Two additional intraindividual studies: 4 of 119 and 2 of 121 participants withdrew because of adverse events and one of them was related to MAL‐PDT. GRADE = low

Skin irritation

Cryotherapy /Betulin‐based oleogel

Not reported

Cryotherapy/cryotherapy with betulin‐based oleogel

Not reported

Cryotherapy/5% 5‐FU

Not reported

Vehicle with cryotherapy/0.5% 5‐FU with cryotherapy

Not reported

Cryotherapy /Imiquimod

Not reported

Cryotherapy with vehicle /Cryotherapy with imiquimod

Study population

RR 0.39
(0.1 to 1.54)

311
(2 studies)

⊕⊕⊕⊝
moderate

Pooled data (5% and 3.75% imiquimod)

(Analysis 64.7)

83 per 1000

32 per 1000
(8 to 128)

Moderate

125 per 1000

49 per 1000
(13 to 192)

Cryotherapy /ALA‐red light PDT

372 per 1000

100 per 1000
(59 to 171)

RR 0.27
(0.16 to 0.46)

297
(1 study)

⊕⊕⊝⊝
low

Assessment one day after the treatment (Analysis 46.2)

Cryotherapy/MAL‐red light PDT

Not reported

Figuras y tablas -
Table 4. Overview for cryotherapy
Table 5. Overview for imiquimod

Imiquimod compared to interventions for actinic keratoses in immunocompetent participants

Intervention/Comparison intervention

Illustrative comparative risks*  (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

With comparator

With intervention

Participant complete clearance

2.5% imiquimod/placebo

62 per 1000

277 per 1000
(148 to 518)

RR 4.49
(2.4 to 8.39)

486
(2 studies)

⊕⊕⊕⊕
high

(Analysis 20.1)

3.75% imiquimod/placebo

Study population

RR 6.45
(3.87 to 10.73)

730
(3 studies)

⊕⊕⊕⊕
high

(Analysis 20.1)

53 per 1000

343 per 1000
(206 to 571)

Moderate

50 per 1000

322 per 1000
(193 to 536)

Cryotherapy + 3.75% imiquimod/Cryotherapy + vehicle

33 per 1000

301 per 1000
(111 to 820)

RR 9.12
(3.36 to 24.79)

247
(1 study)

⊕⊕⊕⊝
moderate

For all lesions

(Analysis 65.1)

5% imiquimod/placebo

Study population

RR 7.70
(4.63 to 12.79)

1871
(9 studies)

⊕⊕⊕⊕
high

(Analysis 20.1)

48 per 1000

371 per 1000
(223 to 617)

Moderate

32 per 1000

246 per 1000
(148 to 409)

5% imiquimod/3% diclofenac in 2.5% hyaluronic acid

Not reported

5% imiquimod /5% 5‐FU

See comment

See comment

89
(2 studies)

⊕⊝⊝⊝
very low

The two studies was associated with high heterogeneity (I²= 93%) and the results could not be pooled together. One study favoured 5‐FU (RR 0.31, 95% CI 0.14 to 0.67] whereas the other did not (RR 0.88, 95% CI 0.73 to 1.06] (Analysis 22.1)

5% imiquimod/Cryotherapy

680 per 1000

843 per 1000
(619 to 1000)

RR 1.24
(0.91 to 1.7)

51
(1 study)

⊕⊝⊝⊝
very low

(Analysis 23.1)

Cryotherapy + 5% imiquimod/Cryotherapy + vehicle

91 per 1000

225 per 1000
(64 to 796)

RR 2.48
(0.70 to 8.76)

64
(1 study)

⊕⊕⊝⊝
low

For all lesions.(Analysis 65.1) Results from an additional intraindividual study:  cryotherapy + imiquimod side (8/27 = 30%), cryotherapy alone side (5/27 = 19%), GRADE = low

5% imiquimod/ALA‐PDT

Not reported

ALA‐PDT + 5% imiquimod/ALA‐PDT + placebo

See comment

See comment

Not estimable

25
(1 study)

⊕⊕⊝⊝
low

Intraindividual study: ALA‐PDT + 5% imiquimod = 2/25; ALA‐PDT + placebo = 2/25

Mean reduction in lesion counts

2.5% imiquimod/placebo

Not reported

3.75% imiquimod/placebo

Not reported

Cryotherapy + 3.75% imiquimod/Cryotherapy + vehicle

Not reported

5% imiquimod/placebo

The mean reduction in lesion counts in the control groups was
0.6 lesions

The mean reduction in lesion counts in the intervention groups was 2.20 higher
(1.05 lower to 5.45 higher)

12
(1 study)

⊕⊕⊝⊝
low

(Analysis 19.5)

Results from an additional intraindividual study with no SD (N = 21): 5% imiquimod: 3.9 lesions, placebo = 0.5 lesions, GRADE = very low

5% imiquimod/3% diclofenac in 2.5% hyaluronic acid

Not reported

5% imiquimod /5% 5‐FU

Not reported

5% imiquimod/Cryotherapy

Not reported

Cryotherapy + 5% imiquimod/Cryotherapy + vehicle

Not reported

5% imiquimod/ALA‐PDT

Not reported

ALA‐PDT + 5% imiquimod/ALA‐PDT + placebo

See comment

See comment

Not estimable

25
(1 study)

⊕⊕⊝⊝
low

Results from intraindividual study without SD: ALA‐PDT + 5% imiquimod= 19.9 lesions; ALA‐PDT + placebo= 16.0 lesions

Mean percentage of reduction in lesion counts

2.5% imiquimod/placebo

Not reported

3.75% imiquimod/placebo

The mean percentage of reduction in lesion counts in the control groups was
21.1 per cent

The mean percentage of reduction in lesion counts in the intervention groups was 46.90 higher
(36.68 to 57.12 higher)

247
(1 study)

⊕⊕⊕⊝
moderate

(Analysis 20.3)

Cryotherapy + 3.75% imiquimod/Cryotherapy + vehicle

The mean percentage of reduction in lesion counts in the control groups was
43.3 per cent

The mean percentage of reduction in lesion counts in the intervention groups was 34.1 higher
(26.82 to 41.38 higher)

247
(1 study)

⊕⊕⊕⊝
moderate

For all lesions (Analysis 65.2)

5% imiquimod/placebo

Not reported

5% imiquimod/3% diclofenac in 2.5% hyaluronic acid

Not reported

5% imiquimod /5% 5‐FU

See comment

See comment

Not estimable

39
(1 study)

⊕⊕⊝⊝
low

Results with no SD: 5% imiquimod = 66%, 5% 5‐FU = 94%

5% imiquimod/Cryotherapy

Not reported

Cryotherapy + 5% imiquimod/Cryotherapy + vehicle

The mean percentage of reduction in lesion counts in the control groups was
62 per cent

The mean percentage of reduction in lesion counts in the intervention groups was 11.2 higher
(4.13 lower to 26.53 higher)

27
(1 study)

⊕⊕⊝⊝
low

For all lesions.(Analysis 65.2) Results from an additional intraindividual study: cryotherapy‐5% imiquimod = 73.2+27.1%, cryotherapy + vehicle = 62.0+30.3%. GRADE = moderate

5% imiquimod/ALA‐PDT

Not reported

ALA‐PDT + 5% imiquimod/ALA‐PDT + placebo

See comment

See comment

Not estimable

25
(1 study)

⊕⊕⊝⊝
low

Results from intraindividual study without SD: ALA‐PDT + 5% imiquimod = 86.7% ; ALA‐PDT + placebo = 73.1 %

Withdrawal due to adverse events

2.5% imiquimod/placebo

19 per 1000

9 per 1000
(2 to 50)

RR 0.5
(0.09 to 2.7)

486
(2 studies)

⊕⊕⊕⊝
moderate

(Analysis 20.5)

3.75% imiquimod/placebo

19 per 1000

17 per 1000
(4 to 73)

RR 0.92
(0.22 to 3.93)

483
(2 studies)

⊕⊕⊕⊝
moderate

(Analysis 20.5)

Cryotherapy + 3.75% imiquimod/Cryotherapy + vehicle

32 per 1000

41 per 1000
(11 to 150)

RR 1.3
(0.36 to 4.73)

247
(1 study)

⊕⊕⊝⊝
low

(Analysis 65.3)

5% imiquimod/placebo

Study population

RR 2.59
(1.59 to 4.23)

2290
(8 studies)

⊕⊕⊕⊝
moderate

(Analysis 20.5) Four small sample size studies with no participant withdrawal are not included in meta‐analysis: pooled data, imiquimod 0/79 and placebo 0/31. Additional two intraindividual studies: no participant withdrew because of adverse events (0/42) GRADE  = very low (both studies had more  than 20% participant lost).

21 per 1000

56 per 1000
(34 to 91)

Moderate

5 per 1000

13 per 1000
(8 to 22)

High

0 per 1000

0 per 1000
(0 to 0)

5% imiquimod/3% diclofenac in 2.5% hyaluronic acid

0 per 1000

0 per 1000

Not estimable

49
(1 study)

⊕⊕⊕⊝
moderate

There were no participant withdrawals due to adverse events.

5% imiquimod /5% 5‐FU

0 per 1000

0 per 1000

Not estimable

50
(1 study)

⊕⊕⊕⊝
moderate

There were no participant withdrawals due to adverse events.

5% imiquimod/Cryotherapy

0 per 1000

0 per 1000

Not estimable

51
(1 study)

⊕⊕⊕⊝
moderate

There were no participant withdrawals due to adverse events.

Cryotherapy + 5% imiquimod/Cryotherapy + vehicle

30 per 1000

10 per 1000
(0 to 246)

RR 0.34
(0.01 to 8.13)

65
(1 study)

⊕⊕⊝⊝
low

(Analysis 65.3)

5% imiquimod/ALA‐PDT

0 per 1000

0 per 1000

Not estimable

30
(1 study)

⊕⊕⊝⊝
low

There were no participant withdrawals due to adverse events.

ALA‐PDT + 5% imiquimod/ALA‐PDT + placebo

0 per 1000

0 per 1000

Not estimable

25
(1 study)

⊕⊕⊝⊝
low

There were no participant withdrawals due to adverse events.

Skin irritation

2.5% imiquimod/placebo

6 per 1000

21 per 1000
(4 to 117)

RR 3.45
(0.63 to 18.97)

486
(2 studies)

⊕⊕⊕⊝
moderate

(Analysis 20.6)

3.75% imiquimod/placebo

6 per 1000

30 per 1000
(6 to 159)

RR 4.86
(0.92 to 25.83)

484
(2 studies)

⊕⊕⊕⊝
moderate

(Analysis 20.6)

Cryotherapy + 3.75% imiquimod/Cryotherapy + vehicle

8 per 1000

56 per 1000
(7 to 445)

RR 6.72
(0.84 to 53.83)

247
(1 study)

⊕⊕⊝⊝
low

(Analysis 65.4)

5% imiquimod/placebo

5 per 1000

18 per 1000
(4 to 79)

RR 3.68
(0.86 to 15.74)

708
(3 studies)

⊕⊕⊕⊝
moderate

(Analysis 20.6)

Additional intraindividual study: similar mild irritation between the two treatment sides (N = 20) GRADE = very low

5% imiquimod/3% diclofenac in 2.5% hyaluronic acid

Not reported

5% imiquimod/5% 5‐FU

Not reported

5% imiquimod/Cryotherapy

Not reported

Cryotherapy + 5% imiquimod/Cryotherapy + vehicle

121 per 1000

194 per 1000
(61 to 622)

RR 1.6
(0.5 to 5.13)

64
(1 study)

⊕⊕⊝⊝
low

(Analysis 65.4)

5% imiquimod/ALA‐PDT

Not reported

ALA‐PDT + 5% imiquimod/ALA‐PDT + placebo

Not reported

Figuras y tablas -
Table 5. Overview for imiquimod
Comparison 1. Adapalene gel versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Global Improvement Indices (investigator)‐cleared Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2 Mean changes in lesion counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

2.1 0.1% adapalene gel

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 0.3% adapalene gel

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3 Withdrawal due to adverse events Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

4 Minor adverse events excluding skin irritation: dermatitis Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 1. Adapalene gel versus placebo
Comparison 2. 0.1% adapalene vs 0.3% adapalene

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Global Improvement Indices (investigator)‐cleared Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2 Mean changes in lesion counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

3 Withdrawal due to adverse events Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

4 Minor adverse events excluding skin irritation: dermatitis Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 2. 0.1% adapalene vs 0.3% adapalene
Comparison 3. Arotinoid Methyl Sulfone (Ro 14‐9706) versus Tretinoin

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean percentage of reduction in lesion counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 3. Arotinoid Methyl Sulfone (Ro 14‐9706) versus Tretinoin
Comparison 4. Calcipotriol (vitamin D) versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean changes in lesion counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

2 Cosmetic outcomes: Reduction in total cosmetic appearance score Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 4. Calcipotriol (vitamin D) versus placebo
Comparison 5. 1% colchicine cream versus 0.5% colchicine cream

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2 Mean reduction in lesion counts‐total Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

3 Mean reduction in lesion counts‐per anatomical locations Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

3.1 Face

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.2 Scalp

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.3 Upper extremities

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4 Cosmetic outcomes: Number of participants with decreased infiltration and disappearance of crust Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 5. 1% colchicine cream versus 0.5% colchicine cream
Comparison 6. 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Investigator Global Improvement Indices‐completely improved Show forest plot

2

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

1.1 30 day treatment/30 day follow‐up

1

98

Risk Ratio (M‐H, Random, 95% CI)

4.0 [0.89, 17.89]

1.2 60 day treatment/30 day follow‐up

1

97

Risk Ratio (M‐H, Random, 95% CI)

3.06 [1.21, 7.77]

1.3 90 day treatment/30 day follow‐up

1

117

Risk Ratio (M‐H, Random, 95% CI)

2.50 [1.37, 4.55]

2 Participant Global Improvement Indices‐completely improved Show forest plot

2

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

2.1 30 day treatment/30 day follow‐up

1

98

Risk Ratio (M‐H, Random, 95% CI)

4.0 [0.89, 17.89]

2.2 60 day treatment/30 day follow‐up

1

97

Risk Ratio (M‐H, Random, 95% CI)

2.86 [1.12, 7.32]

2.3 90 day treatment/30 day follow‐up

1

117

Risk Ratio (M‐H, Random, 95% CI)

2.44 [1.28, 4.64]

3 Participant complete clearance at end of treatment (>56 days) Show forest plot

2

280

Risk Ratio (M‐H, Random, 95% CI)

1.95 [1.21, 3.13]

4 Participant complete clearance (target lesions) Show forest plot

3

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

4.1 30 day treatment/ 30 day follow‐up

1

98

Risk Ratio (M‐H, Random, 95% CI)

3.5 [0.76, 16.01]

4.2 60 day treatment/ 30 day follow‐up

1

97

Risk Ratio (M‐H, Random, 95% CI)

3.27 [1.30, 8.21]

4.3 90 day treatment/ 30 day follow‐up

2

267

Risk Ratio (M‐H, Random, 95% CI)

2.87 [1.84, 4.48]

5 Participant complete clearance (all lesions) Show forest plot

3

420

Risk Ratio (M‐H, Random, 95% CI)

2.46 [1.66, 3.66]

5.1 30 day treatment/ 30 day follow‐up

1

98

Risk Ratio (M‐H, Random, 95% CI)

3.5 [0.76, 16.01]

5.2 60 day treatment/ 30 day follow‐up

1

97

Risk Ratio (M‐H, Random, 95% CI)

3.83 [1.37, 10.71]

5.3 90 day treatment/30 day follow‐up

2

225

Risk Ratio (M‐H, Random, 95% CI)

2.20 [1.40, 3.44]

6 Participant complete clearance for 30 day treatment by locations Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

6.1 Scalp

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.2 Forehead

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.3 Face

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.4 Back of hand

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7 Participant complete clearance for 60 day treatment by locations Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

7.1 Scalp

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.2 Forehead

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.3 Face

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.4 Arm/forearm

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.5 Back of hand

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8 Participant complete clearance for 90 day treatment by locations Show forest plot

2

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

8.1 Scalp

2

23

Risk Ratio (M‐H, Random, 95% CI)

1.24 [0.25, 6.08]

8.2 Forehead

2

95

Risk Ratio (M‐H, Random, 95% CI)

1.71 [1.03, 2.85]

8.3 Face

2

47

Risk Ratio (M‐H, Random, 95% CI)

2.15 [1.05, 4.40]

8.4 Arm/forearm

2

37

Risk Ratio (M‐H, Random, 95% CI)

1.94 [0.26, 14.40]

8.5 Back of hand

2

63

Risk Ratio (M‐H, Random, 95% CI)

1.71 [0.04, 65.87]

9 Participant complete clearance in immunosuppressed participants Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

10 Participant partial (>75%) clearance in immunosuppressed participants Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

11 Mean reduction of lesion counts (30‐90 days ): At the end of study Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Subtotals only

11.1 90 days

1

150

Mean Difference (IV, Random, 95% CI)

0.80 [‐1.48, 3.08]

12 Mean reduction of lesion counts (30‐90 days): 30 day follow‐up Show forest plot

2

345

Mean Difference (IV, Random, 95% CI)

2.55 [1.56, 3.53]

12.1 30 days

1

98

Mean Difference (IV, Random, 95% CI)

2.00 [0.63, 3.37]

12.2 60 days

1

97

Mean Difference (IV, Random, 95% CI)

2.40 [0.73, 4.07]

12.3 90 days

1

150

Mean Difference (IV, Random, 95% CI)

3.80 [1.83, 5.77]

13 Withdrawal due to adverse events Show forest plot

4

592

Risk Ratio (M‐H, Random, 95% CI)

3.59 [1.92, 6.70]

14 Minor adverse event: body as a whole : in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

15 Minor adverse event: body as a whole : "flu" Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

16 Minor adverse event:: body as a whole : infection Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

17 Minor adverse event: cardiovascular: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

18 Minor adverse event: cardiovascular: sinus bradycardia Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

19 Minor adverse event: dermatological: bursitis Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

20 Minor adverse event: dermatological: dry skin Show forest plot

3

462

Risk Ratio (M‐H, Random, 95% CI)

2.40 [1.20, 4.78]

21 Minor adverse event: dermatological: herpes zoster Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

22 Minor adverse event: dermatological: rash vesiculobullous Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

23 Minor adverse event::dermatological: seborrhoea Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

24 Minor adverse event: dermatological: skin exfoliation Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

25 Minor adverse event: dermatological: ulcerated skin Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

26 Minor adverse event: digestive : in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

27 Minor adverse event: hemic and lymphatic: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

28 Minor adverse event: metabolic and nutritional disorders : in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

29 Minor adverse event: musculoskeletal and connective tissue: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

30 Minor adverse event: musculoskeletal and connective tissue: hypokinesia Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

31 Minor adverse event: nervous system: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

32 Minor adverse event: nervous system: headache Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

33 Minor adverse event: nervous system: hyperaesthesia Show forest plot

2

345

Risk Ratio (M‐H, Random, 95% CI)

0.88 [0.30, 2.60]

34 Minor adverse event: nervous system: paraesthesia Show forest plot

2

345

Risk Ratio (M‐H, Random, 95% CI)

2.53 [0.57, 11.20]

35 Minor adverse event: respiratory: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

36 Minor adverse event: respiratory: bronchitis Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

37 Minor adverse event: respiratory: pharyngitis Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

38 Minor adverse event: respiratory: upper respiratory tract infection Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

39 Minor adverse event: special senses: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

40 Minor adverse event: urogenital: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 6. 3% diclofenac in 2.5% hyaluronic acid versus 2.5% hyaluronic acid (vehicle)
Comparison 7. 3% diclofenac in 2.5% hyaluronic acid versus 5% imiquimod

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Investigator Global Improvement Indices‐Complete improvement Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2 Participant Global Improvement Indices‐Complete improvement Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 7. 3% diclofenac in 2.5% hyaluronic acid versus 5% imiquimod
Comparison 8. 2‐(Difluoromethyl)‐dl‐ornithine (DFMO) versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean reduction in lesions counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 8. 2‐(Difluoromethyl)‐dl‐ornithine (DFMO) versus placebo
Comparison 9. 0.5% 5‐FU versus vehicle

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

3

522

Risk Ratio (M‐H, Random, 95% CI)

8.86 [3.67, 21.40]

1.1 1 week treatment with 4 week follow‐up

3

267

Risk Ratio (M‐H, Random, 95% CI)

8.30 [2.04, 33.76]

1.2 2 week treatment with 4 week follow‐up

2

128

Risk Ratio (M‐H, Random, 95% CI)

6.42 [1.27, 32.59]

1.3 4 week treatment with 4 week follow‐up

2

127

Risk Ratio (M‐H, Random, 95% CI)

13.07 [2.68, 63.66]

2 Mean reduction in lesion counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

3 Mean percentage of reduction in lesion counts Show forest plot

1

142

Mean Difference (IV, Random, 95% CI)

33.60 [22.88, 44.32]

4 Withdrawal due to adverse events Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

5 Skin irritation Show forest plot

2

384

Risk Ratio (M‐H, Random, 95% CI)

1.45 [1.27, 1.65]

6 Minor adverse event excluding skin irritation: body as a whole : in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

7 Minor adverse event excluding skin irritation: body as a whole : allergy Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

8 Minor adverse event excluding skin irritation: body as a whole : "flu" or common cold Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

9 Minor adverse event excluding skin irritation: musculoskeletal and connective tissue: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

10 Minor adverse event excluding skin irritation: musculoskeletal and connective tissue: soreness Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

11 Minor adverse event excluding skin irritation:nervous system: headache Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

12 Minor adverse event excluding skin irritation: respiratory: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

13 Minor adverse event excluding skin irritation: respiratory: sinusitis Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

14 Minor adverse event excluding skin irritation: respiratory: upper respiratory tract infection Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

15 Minor adverse event excluding skin irritation: special senses: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

16 Minor adverse event excluding skin irritation:special senses: eye irritation Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 9. 0.5% 5‐FU versus vehicle
Comparison 10. 0.5% 5‐FU at varying application durations

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

2

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

1.1 Daily for 1 week versus 4 weeks

2

167

Risk Ratio (M‐H, Random, 95% CI)

0.39 [0.19, 0.81]

1.2 Daily for 1 week versus 2 weeks

2

169

Risk Ratio (M‐H, Random, 95% CI)

0.74 [0.23, 2.37]

1.3 Daily for 2 weeks versus 4 weeks

2

171

Risk Ratio (M‐H, Random, 95% CI)

0.56 [0.36, 0.87]

2 Withdrawal due to adverse events Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2.1 Daily for 1 week versus 4 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 Daily for 1 week versus 2 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.3 Daily for 2 weeks versus 4 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3 Skin irritation Show forest plot

2

515

Risk Ratio (M‐H, Random, 95% CI)

0.95 [0.91, 1.00]

3.1 Daily for 1 week versus 4 weeks

2

170

Risk Ratio (M‐H, Random, 95% CI)

0.96 [0.89, 1.03]

3.2 Daily for 1 week versus 2 weeks

2

172

Risk Ratio (M‐H, Random, 95% CI)

0.96 [0.86, 1.08]

3.3 Daily for 2 weeks versus 4 weeks

2

173

Risk Ratio (M‐H, Random, 95% CI)

0.94 [0.88, 1.02]

4 Minor adverse events excluding skin irritation: body as a whole : in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

4.1 Daily for 1 week versus 4 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4.2 Daily for 1 week versus 2 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4.3 Daily for 2 weeks versus 4 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

5 Minor adverse events excluding skin irritation: body as a whole : allergy Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

5.1 Daily for 1 week versus 4 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

5.2 Daily for 1 week versus 2 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

5.3 Daily for 2 weeks versus 4 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6 Minor adverse events excluding skin irritation: body as a whole : "flu" or common cold Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

6.1 Daily for 1 week versus 4 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.2 Daily for 1 week versus 2 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.3 Daily for 2 weeks versus 4 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

7.1 Daily for 1 week versus 4 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.2 Daily for 1 week versus 2 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.3 Daily for 2 weeks versus 4 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8 Minor adverse events excluding skin irritation: nervous system: headache Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

8.1 Daily for 1 week versus 4 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.2 Daily for 1 week versus 2 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.3 Daily for 2 weeks versus 4 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9 Minor adverse events excluding skin irritation: respiratory: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

9.1 Daily for 1 week versus 4 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.2 Daily for 1 week versus 2 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.3 Daily for 2 weeks versus 4 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10 Minor adverse events excluding skin irritation: respiratory: sinusitis Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

10.1 Daily for 1 week versus 4 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.2 Daily for 1 week versus 2 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.3 Daily for 2 weeks versus 4 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

11 Minor adverse events excluding skin irritation: special senses: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

11.1 Daily for 1 week versus 4 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

11.2 Daily for 1 week versus 2 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

11.3 Daily for 2 weeks versus 4 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

12 Minor adverse events excluding skin irritation: special senses: eye irritation Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

12.1 Daily for 1 week versus 4 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

12.2 Daily for 1 week versus 2 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

12.3 Daily for 2 weeks versus 4 weeks

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figuras y tablas -
Comparison 10. 0.5% 5‐FU at varying application durations
Comparison 11. 0.5% 5‐FU versus ALA‐PDT

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

1.1 Blue light

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 Pulsed dye laser

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 Combined

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Withdrawal due to adverse events Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2.1 Blue light

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 Pulsed dye laser

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.3 Combined

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figuras y tablas -
Comparison 11. 0.5% 5‐FU versus ALA‐PDT
Comparison 12. 5% 5‐FU with 0.05% tretinoin versus 5% 5‐FU with placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean reduction in lesion counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 12. 5% 5‐FU with 0.05% tretinoin versus 5% 5‐FU with placebo
Comparison 13. 5% 5‐FU versus 5% imiquimod

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

2

89

Risk Ratio (M‐H, Random, 95% CI)

1.85 [0.41, 8.33]

Figuras y tablas -
Comparison 13. 5% 5‐FU versus 5% imiquimod
Comparison 14. 5% 5‐FU versus cryotherapy

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

1.1 After treatment

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 At 12 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figuras y tablas -
Comparison 14. 5% 5‐FU versus cryotherapy
Comparison 15. 5% 5‐FU versus 10% masoprocol

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Investigator Global Improvement Indices ‐cleared Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2 Mean reduction of lesion counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

3 Mean percentage of reduction of lesion counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

4 Withdrawal due to adverse events Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 15. 5% 5‐FU versus 10% masoprocol
Comparison 16. 5% 5‐FU versus carbon dioxide laser resurfacing

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean percentage of reduction of lesion counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

2 Withdrawal due to adverse events Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 16. 5% 5‐FU versus carbon dioxide laser resurfacing
Comparison 17. 5% 5‐FU versus Er:YAG laser resurfacing

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Withdrawal due to adverse events Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2 Skin irritation Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2.1 At the end of treatment

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 At 3 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.3 At 6 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figuras y tablas -
Comparison 17. 5% 5‐FU versus Er:YAG laser resurfacing
Comparison 18. 5% 5‐FU versus Trichloroacetic acid peel

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean percentage of reduction in lesions Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 18. 5% 5‐FU versus Trichloroacetic acid peel
Comparison 19. 5% Imiquimod versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance‐number of doses Show forest plot

11

2880

Risk Ratio (M‐H, Random, 95% CI)

6.91 [4.25, 11.26]

1.1 9 or 18 doses (3 times/week for 3 weeks on, 4 weeks off)

1

39

Risk Ratio (M‐H, Random, 95% CI)

2.76 [0.39, 19.40]

1.2 12‐16 doses (2 times/week for 8 weeks or 3 times/week for 4 weeks)

3

543

Risk Ratio (M‐H, Random, 95% CI)

7.88 [1.09, 56.67]

1.3 12 or 24 doses (3 times/week for 4 weeks on , 4 weeks off, 4 weeks on)

2

505

Risk Ratio (M‐H, Random, 95% CI)

8.81 [1.15, 67.32]

1.4 24 doses (3 times/week for 8 weeks)

1

36

Risk Ratio (M‐H, Random, 95% CI)

1.33 [0.07, 25.08]

1.5 32‐36 doses (2 times/ week for 16 weeks or 3 times/ week for 12 weeks)

4

888

Risk Ratio (M‐H, Random, 95% CI)

7.12 [3.06, 16.58]

1.6 40 doses (5 times/week for 8 weeks)

1

37

Risk Ratio (M‐H, Random, 95% CI)

0.77 [0.03, 17.27]

1.7 48 doses (3 times/ week for 16 weeks)

3

795

Risk Ratio (M‐H, Random, 95% CI)

10.90 [3.59, 33.15]

1.8 56 doses (7 times/week for 8 weeks)

1

37

Risk Ratio (M‐H, Random, 95% CI)

1.29 [0.07, 24.29]

2 Participant complete clearance in immunosuppressed participants Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

3 Participant partial (>75%) clearance Show forest plot

7

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

3.1 9 or 18 doses (3 times/ week for 3 weeks on, 4 weeks off. 3 weeks on)

1

39

Risk Ratio (M‐H, Random, 95% CI)

2.41 [0.91, 6.39]

3.2 12‐16 doses (3 times/week for 4 weeks or 2 times/week for 8 weeks)

2

284

Risk Ratio (M‐H, Random, 95% CI)

2.86 [1.53, 5.34]

3.3 12 or 24 doses (3 times/week for 4 weeks on, 4 weeks off)

2

505

Risk Ratio (M‐H, Random, 95% CI)

6.23 [0.70, 55.10]

3.4 24 doses (3 times/week for 8 weeks)

1

36

Risk Ratio (M‐H, Random, 95% CI)

4.0 [0.25, 62.85]

3.5 32 doses (2 times/week for 16 weeks)

1

436

Risk Ratio (M‐H, Random, 95% CI)

5.02 [3.44, 7.33]

3.6 40 doses (5 times/week for 8 weeks)

1

37

Risk Ratio (M‐H, Random, 95% CI)

3.35 [0.21, 53.51]

3.7 48 doses (3 times/ week for 16 weeks)

2

778

Risk Ratio (M‐H, Random, 95% CI)

8.46 [2.29, 31.16]

3.8 56 doses (7 times/week for 8 weeks)

1

37

Risk Ratio (M‐H, Random, 95% CI)

5.94 [0.39, 90.34]

4 Participant partial (>75%) clearance in immunosuppressed participants Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

5 Mean reduction in lesion counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

6 Withdrawal due to adverse events Show forest plot

8

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

6.1 12‐16 doses (2 times/week for 8 weeks or 3 times/week for 4 weeks)

1

38

Risk Ratio (M‐H, Random, 95% CI)

0.75 [0.03, 16.74]

6.2 12 or 24 doses (3 times/week for 4 weeks on , 4 weeks off, 4 weeks on)

2

505

Risk Ratio (M‐H, Random, 95% CI)

1.60 [0.31, 8.23]

6.3 24 doses (3 times/week for 8 weeks)

1

36

Risk Ratio (M‐H, Random, 95% CI)

1.33 [0.07, 25.08]

6.4 32‐36 doses (2 times/ week for 16 weeks or 3 times/ week for 12 weeks)

3

858

Risk Ratio (M‐H, Random, 95% CI)

2.29 [0.80, 6.57]

6.5 40 doses (5 times/week for 8 weeks)

1

37

Risk Ratio (M‐H, Random, 95% CI)

4.90 [0.32, 75.60]

6.6 48 doses (3 times/ week for 16 weeks)

2

778

Risk Ratio (M‐H, Random, 95% CI)

2.69 [1.48, 4.90]

6.7 56 doses (7 times/week for 8 weeks)

1

37

Risk Ratio (M‐H, Random, 95% CI)

5.42 [0.35, 82.97]

7 Withdrawal due to adverse events in immunosuppressed participants Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

7.1 48 doses (3 times/ week for 16 weeks)

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8 Minor adverse events excluding skin irritation: body as a whole: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

8.1 12‐16 doses

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.2 24‐28 doses

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.3 40 doses

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.4 56 doses

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9 Minor adverse events excluding skin irritation: body as a whole: "flu" or "cold" Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

9.1 12‐16 doses

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.2 24‐28 doses

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.3 40 doses

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.4 56 doses

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10 Minor adverse events excluding skin irritation: digestive: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

10.1 12‐16 doses

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.2 24‐28 doses

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.3 40 doses

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.4 56 doses

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

11 Minor adverse events excluding skin irritation: digestive: nausea Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

11.1 12‐16 doses

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

11.2 24‐28 doses

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

11.3 40 doses

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

11.4 56 doses

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

12 Minor adverse events excluding skin irritation: nervous system: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

12.1 12‐16 doses

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

12.2 24‐28 doses

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

12.3 40 doses

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

12.4 56 doses

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

13 Cosmetic outcome: decrease in roughness/dryness/scaliness of the skin Show forest plot

2

683

Risk Ratio (M‐H, Random, 95% CI)

3.23 [1.86, 5.58]

13.1 32‐36 doses

1

415

Risk Ratio (M‐H, Random, 95% CI)

2.54 [1.91, 3.37]

13.2 48 doses

1

268

Risk Ratio (M‐H, Random, 95% CI)

4.43 [2.69, 7.30]

Figuras y tablas -
Comparison 19. 5% Imiquimod versus placebo
Comparison 20. Imiquimod versus placebo: different concentrations

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

12

3087

Risk Ratio (M‐H, Random, 95% CI)

6.73 [5.03, 9.00]

1.1 5.0% imiquimod

9

1871

Risk Ratio (M‐H, Random, 95% CI)

7.70 [4.63, 12.79]

1.2 3.75% imiquimod

3

730

Risk Ratio (M‐H, Random, 95% CI)

6.45 [3.87, 10.73]

1.3 2.5% imiquimod

2

486

Risk Ratio (M‐H, Random, 95% CI)

4.49 [2.40, 8.39]

2 Participant partial (>75%) clearance Show forest plot

6

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

2.1 5.0% imiquimod

4

1363

Risk Ratio (M‐H, Random, 95% CI)

6.71 [3.89, 11.57]

2.2 3.75% imiquimod

2

484

Risk Ratio (M‐H, Random, 95% CI)

3.11 [2.08, 4.66]

2.3 2.5% imiquimod

2

485

Risk Ratio (M‐H, Random, 95% CI)

2.48 [1.67, 3.68]

3 Mean percentage of reduction in lesion counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

3.1 3.75% imiquimod

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4 Minor adverse events excluding skin irritation: body as a whole: 'flu" or "cold" Show forest plot

2

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

4.1 5.0% imiquimod

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4.2 3.75% imiquimod

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4.3 2.5% imiquimod

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

5 Withdrawal due to adverse events Show forest plot

10

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

5.1 5.0% imiquimod

8

2290

Risk Ratio (M‐H, Random, 95% CI)

2.59 [1.59, 4.23]

5.2 3.75% imiquimod

2

483

Risk Ratio (M‐H, Random, 95% CI)

0.92 [0.22, 3.93]

5.3 2.5% imiquimod

2

486

Risk Ratio (M‐H, Random, 95% CI)

0.50 [0.09, 2.70]

6 Skin irritation Show forest plot

5

1678

Risk Ratio (M‐H, Random, 95% CI)

3.93 [1.56, 9.88]

6.1 5.0% imiquimod

3

708

Risk Ratio (M‐H, Random, 95% CI)

3.68 [0.86, 15.74]

6.2 3.75% imiquimod

2

484

Risk Ratio (M‐H, Random, 95% CI)

4.86 [0.92, 25.83]

6.3 2.5% imiquimod

2

486

Risk Ratio (M‐H, Random, 95% CI)

3.45 [0.63, 18.97]

7 Minor adverse events excluding skin irritation: body as a whole: pyrexia Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

7.1 3.75% imiquimod

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.2 2.5% imiquimod

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8 Minor adverse events excluding skin irritation: hemic and lymphatic: lymphadenopathy Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

8.1 3.75% imiquimod

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.2 2.5% imiquimod

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: myalgia Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

9.1 3.75% imiquimod

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10 Minor adverse events excluding skin irritation: nervous system: fatigue Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

10.1 3.75% imiquimod

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.2 2.5% imiquimod

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

11 Minor adverse events excluding skin irritation: nervous system: headache Show forest plot

2

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

11.1 5.0% imiquimod

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

11.2 3.75% imiquimod

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

11.3 2.5% imiquimod

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

12 Minor adverse events excluding skin irritation: respiratory: cough Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

12.1 3.75% imiquimod

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

12.2 2.5% imiquimod

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

13 Minor adverse events excluding skin irritation: respiratory: sinusitis Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

13.1 3.75% imiquimod

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

13.2 2.5% imiquimod

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

14 Minor adverse events excluding skin irritation: respiratory: upper respiratory tract infection Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

14.1 3.75% imiquimod

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

14.2 2.5% imiquimod

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

15 Minor adverse events excluding skin irritation: urogenital: urinary tract infection Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

15.1 3.75% imiquimod

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

15.2 2.5% imiquimod

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

16 Cosmetic outcome: Participant's significantly or much improved cosmetic outcome assessed by investigator Show forest plot

2

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

16.1 3.75% imiquimod

2

470

Risk Ratio (M‐H, Random, 95% CI)

2.71 [2.05, 3.58]

16.2 2.5% imiquimod

2

475

Risk Ratio (M‐H, Random, 95% CI)

2.25 [1.62, 3.14]

Figuras y tablas -
Comparison 20. Imiquimod versus placebo: different concentrations
Comparison 21. Imiquimod versus placebo: frequency of application

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

12

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

1.1 2 times/week

4

890

Risk Ratio (M‐H, Random, 95% CI)

5.36 [2.03, 14.16]

1.2 3 times/week

6

1336

Risk Ratio (M‐H, Random, 95% CI)

8.38 [3.79, 18.52]

1.3 5 times/week

1

37

Risk Ratio (M‐H, Random, 95% CI)

0.77 [0.03, 17.27]

1.4 7 times/week

4

1253

Risk Ratio (M‐H, Random, 95% CI)

5.39 [3.65, 7.98]

2 Participant partial (>75%) clearance Show forest plot

6

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

2.1 2 times/week

2

474

Risk Ratio (M‐H, Random, 95% CI)

4.99 [3.43, 7.26]

2.2 3 times/week

3

814

Risk Ratio (M‐H, Random, 95% CI)

7.65 [2.51, 23.32]

2.3 5 times/week

1

37

Risk Ratio (M‐H, Random, 95% CI)

3.35 [0.21, 53.51]

2.4 7 times/week

3

1006

Risk Ratio (M‐H, Random, 95% CI)

2.95 [1.99, 4.37]

3 Withdrawal due to adverse events Show forest plot

10

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

3.1 2 times/week

4

896

Risk Ratio (M‐H, Random, 95% CI)

2.04 [0.75, 5.53]

3.2 3 times/week

5

1319

Risk Ratio (M‐H, Random, 95% CI)

2.47 [1.42, 4.30]

3.3 5 times/week

1

37

Risk Ratio (M‐H, Random, 95% CI)

4.90 [0.32, 75.60]

3.4 7 times/week

3

1006

Risk Ratio (M‐H, Random, 95% CI)

1.55 [0.33, 7.18]

4 Minor adverse events excluding skin irritation:body as a whole: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

4.1 2 times/week

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4.2 3 times/week

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4.3 5 times/week

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4.4 7 times/week

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

5 Minor adverse events excluding skin irritation: body as a whole:"flu" or "cold" Show forest plot

3

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

5.1 2 times/week

1

38

Risk Ratio (M‐H, Random, 95% CI)

0.75 [0.03, 16.74]

5.2 3 times/week

2

54

Risk Ratio (M‐H, Random, 95% CI)

2.67 [0.36, 19.83]

5.3 5 times/week

1

37

Risk Ratio (M‐H, Random, 95% CI)

0.77 [0.03, 17.27]

5.4 7 times/week

2

527

Risk Ratio (M‐H, Random, 95% CI)

5.20 [0.28, 95.18]

6 Minor adverse events excluding skin irritation: digestive: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

6.1 3 times/week

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.2 5 times/week

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.3 7 times/week

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7 Minor adverse events excluding skin irritation: digestive: nausea Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

7.1 3 times/week

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.2 5 times/week

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.3 7 times/week

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8 Minor adverse events excluding skin irritation: nervous system: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

8.1 3 times/week

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.2 7 times/week

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9 Minor adverse events excluding skin irritation: nervous system: headache Show forest plot

3

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

9.1 3 times/week

1

18

Risk Ratio (M‐H, Random, 95% CI)

3.77 [0.23, 63.05]

9.2 5 times/week

1

37

Risk Ratio (M‐H, Random, 95% CI)

1.81 [0.10, 31.53]

9.3 7 times/week

2

527

Risk Ratio (M‐H, Random, 95% CI)

4.48 [0.86, 23.31]

Figuras y tablas -
Comparison 21. Imiquimod versus placebo: frequency of application
Comparison 22. 5% imiquimod versus 5% 5‐FU

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

2

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

2 Cosmetic outcome: Investigator cosmetic outcome "excellent" Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

3 Cosmetic outcome: normal skin surface Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 22. 5% imiquimod versus 5% 5‐FU
Comparison 23. 5% imiquimod versus cryotherapy

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

1.1 5% imiquimod

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figuras y tablas -
Comparison 23. 5% imiquimod versus cryotherapy
Comparison 24. Ingenol mebutate (PEP005) versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance of target lesions Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2 Participant complete clearance of all lesions Show forest plot

2

456

Risk Ratio (M‐H, Random, 95% CI)

4.50 [2.61, 7.74]

3 Participant partial (>75%) clearance of target lesions Show forest plot

2

280

Risk Ratio (M‐H, Random, 95% CI)

2.88 [1.81, 4.58]

4 Cosmetic outcomes: changes in pigmentation Show forest plot

3

514

Risk Ratio (M‐H, Random, 95% CI)

3.36 [0.63, 17.80]

Figuras y tablas -
Comparison 24. Ingenol mebutate (PEP005) versus placebo
Comparison 25. Ingenol mebutate (PEP005) versus placebo: different concentrations

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance of target lesions Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

1.1 0.025% 3 days

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 0.05% 2‐3 days

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Participant complete clearance of all lesions Show forest plot

2

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

2.1 0.025% 3 days

1

70

Risk Ratio (M‐H, Random, 95% CI)

4.0 [1.03, 15.55]

2.2 0.05% 2‐3 days

2

386

Risk Ratio (M‐H, Random, 95% CI)

5.14 [2.75, 9.62]

3 Participant partial (>75%) clearance of target lesions Show forest plot

2

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

3.1 0.0025% 2 days

1

19

Risk Ratio (M‐H, Random, 95% CI)

1.33 [0.21, 8.41]

3.2 0.01% 2 days

1

20

Risk Ratio (M‐H, Random, 95% CI)

0.5 [0.06, 4.23]

3.3 0.025% 3 days

1

70

Risk Ratio (M‐H, Random, 95% CI)

2.8 [1.13, 6.96]

3.4 0.05% 2‐3 days

2

171

Risk Ratio (M‐H, Random, 95% CI)

3.34 [1.84, 6.04]

4 Cosmetic outcomes: changes in pigmentation Show forest plot

2

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

4.1 0.01% 2 days

1

20

Risk Ratio (M‐H, Random, 95% CI)

1.47 [0.08, 25.88]

4.2 0.05% 2 days

2

253

Risk Ratio (M‐H, Random, 95% CI)

4.86 [0.48, 49.39]

Figuras y tablas -
Comparison 25. Ingenol mebutate (PEP005) versus placebo: different concentrations
Comparison 26. 0.05% Ingenol mebutate (PEP005) versus placebo: number of doses

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance of target lesions Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

1.1 0.05% 2 days

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 0.05% 3 days

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Participant complete clearance of all lesions Show forest plot

2

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

2.1 0.05% 2 days

2

319

Risk Ratio (M‐H, Random, 95% CI)

4.32 [2.30, 8.11]

2.2 0.05% 3 days

1

87

Risk Ratio (M‐H, Random, 95% CI)

4.08 [1.59, 10.47]

3 Participant partial (>75%) clearance of target lesions Show forest plot

2

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

3.1 0.05% 2 days

2

104

Risk Ratio (M‐H, Random, 95% CI)

2.65 [1.41, 5.00]

3.2 0.05% 3 days

1

87

Risk Ratio (M‐H, Random, 95% CI)

3.23 [1.66, 6.29]

Figuras y tablas -
Comparison 26. 0.05% Ingenol mebutate (PEP005) versus placebo: number of doses
Comparison 27. Isotretinoin versus vehicle

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Investigator global improvement indices‐completely cleared Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

1.1 Face

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 Scalp

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 Upper extremities

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Mean reduction of lesion counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

2.1 Face

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 Scalp

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.3 Upper extremities

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3 Withdrawal due to adverse events Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

4 Skin irritation Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

5 Severe‐Skin irritation Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 27. Isotretinoin versus vehicle
Comparison 28. Masoprocol versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Global improvement indices‐cured Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2 Mean reduction in lesion counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

3 Withdrawal due to adverse events Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 28. Masoprocol versus placebo
Comparison 29. 1% nicotinamide versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean percentage of reduction in lesion counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

1.1 At 3 months

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 At 6 months

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2 Withdrawal due to adverse events Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 29. 1% nicotinamide versus placebo
Comparison 30. 0.1% resiquimod versus 0.01% resiquimod

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

1.1 After 1 cycle

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 After 1 or 2 cycles

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Participant partial (>75%) clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2.1 After 1 or 2 cycles

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3 Withdrawal due to adverse events Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

4 Minor adverse events excluding skin irritation: body as a whole: fatigue Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

5 Minor adverse events excluding skin irritation: body as a whole: rigors Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

6 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

7 Minor adverse events excluding skin irritation:musculoskeletal and connective tissue: arthralgia Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

8 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: myalgia Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

9 Minor adverse events excluding skin irritation: nervous system: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

10 Minor adverse events excluding skin irritation: nervous system: headache Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

11 Minor adverse events excluding skin irritation: nervous system: lethargy Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

12 Minor adverse events excluding skin irritation: nervous system: psychiatric disorders Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

13 Minor adverse events excluding skin irritation: skin and subcutaneous disorders: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 30. 0.1% resiquimod versus 0.01% resiquimod
Comparison 31. 0.1% resiquimod versus 0.03% resiquimod

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

1.1 After 1 cycle

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 After 1 or 2 cycles

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Participant partial (>75%) clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2.1 After 1 or 2 cycles

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3 Withdrawal due to adverse events Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

4 Minor adverse events excluding skin irritation: body as a whole: fatigue Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

5 Minor adverse events excluding skin irritation: body as a whole: rigors Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

6 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

7 Minor adverse events excluding skin irritation:musculoskeletal and connective tissue: arthralgia Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

8 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: myalgia Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

9 Minor adverse events excluding skin irritation: nervous system: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

10 Minor adverse events excluding skin irritation: nervous system: headache Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

11 Minor adverse events excluding skin irritation: nervous system: lethargy Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

12 Minor adverse events excluding skin irritation: nervous system: psychiatric disorders Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

13 Minor adverse events excluding skin irritation: skin and subcutaneous disorders: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 31. 0.1% resiquimod versus 0.03% resiquimod
Comparison 32. 0.1% resiquimod versus 0.06% resiquimod

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

1.1 After 1 cycle

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 After 1 or 2 cycles

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Participant partial (>75%) clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2.1 After 1 or 2 cycles

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3 Withdrawal due to adverse events Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

4 Minor adverse events excluding skin irritation: body as a whole: fatigue Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

5 Minor adverse events excluding skin irritation: body as a whole: rigors Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

6 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

7 Minor adverse events excluding skin irritation:musculoskeletal and connective tissue: arthralgia Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

8 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: myalgia Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

9 Minor adverse events excluding skin irritation: nervous system: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

10 Minor adverse events excluding skin irritation: nervous system: headache Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

11 Minor adverse events excluding skin irritation: nervous system: lethargy Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

12 Minor adverse events excluding skin irritation: nervous system: psychiatric disorders Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

13 Minor adverse events excluding skin irritation: skin and subcutaneous disorders: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 32. 0.1% resiquimod versus 0.06% resiquimod
Comparison 33. 0.06% resiquimod versus 0.01% resiquimod

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

1.1 After 1 cycle

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 After 1 or 2 cycles

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Participant partial (>75%) clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2.1 After 1 or 2 cycles

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3 Withdrawal due to adverse events Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

4 Minor adverse events excluding skin irritation: body as a whole: fatigue Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

5 Minor adverse events excluding skin irritation: body as a whole: rigors Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

6 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

7 Minor adverse events excluding skin irritation:musculoskeletal and connective tissue: arthralgia Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

8 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: myalgia Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

9 Minor adverse events excluding skin irritation: nervous system: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

10 Minor adverse events excluding skin irritation: nervous system: headache Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

11 Minor adverse events excluding skin irritation: nervous system: lethargy Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

12 Minor adverse events excluding skin irritation: nervous system: psychiatric disorders Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

13 Minor adverse events excluding skin irritation: skin and subcutaneous disorders: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 33. 0.06% resiquimod versus 0.01% resiquimod
Comparison 34. 0.06% resiquimod versus 0.03% resiquimod

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

1.1 After 1 cycle

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 After 1 or 2 cycles

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Participant partial (>75%) clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2.1 After 1 or 2 cycles

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3 Withdrawal due to adverse events Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

4 Minor adverse events excluding skin irritation: body as a whole: fatigue Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

5 Minor adverse events excluding skin irritation: body as a whole: rigors Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

6 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

7 Minor adverse events excluding skin irritation:musculoskeletal and connective tissue: arthralgia Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

8 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: myalgia Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

9 Minor adverse events excluding skin irritation: nervous system: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

10 Minor adverse events excluding skin irritation: nervous system: headache Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

11 Minor adverse events excluding skin irritation: nervous system: lethargy Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

12 Minor adverse events excluding skin irritation: nervous system: psychiatric disorders Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

13 Minor adverse events excluding skin irritation:skin and subcutaneous disorders: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 34. 0.06% resiquimod versus 0.03% resiquimod
Comparison 35. 0.03% resiquimod versus 0.01% resiquimod

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

1.1 After 1 cycle

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 After 1 or 2 cycles

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Participant partial (>75%) clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2.1 After 1 or 2 cycles

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3 Withdrawal due to adverse events Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

4 Minor adverse events excluding skin irritation: body as a whole: fatigue Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

5 Minor adverse events excluding skin irritation: body as a whole: rigors Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

6 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

7 Minor adverse events excluding skin irritation:musculoskeletal and connective tissue: arthralgia Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

8 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: myalgia Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

9 Minor adverse events excluding skin irritation: nervous system: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

10 Minor adverse events excluding skin irritation: nervous system: headache Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

11 Minor adverse events excluding skin irritation: nervous system: lethargy Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

12 Minor adverse events excluding skin irritation: nervous system: psychiatric disorders Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

13 Minor adverse events excluding skin irritation: skin and subcutaneous disorders: in general Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 35. 0.03% resiquimod versus 0.01% resiquimod
Comparison 36. Sunscreen SPF 17 (8% 2‐ethyl‐hexyl p‐methoxycinnamate/2% 4‐tert‐butyl‐4‐methoxy‐4‐dibenzoylmethane) versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean change in lesion counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 36. Sunscreen SPF 17 (8% 2‐ethyl‐hexyl p‐methoxycinnamate/2% 4‐tert‐butyl‐4‐methoxy‐4‐dibenzoylmethane) versus placebo
Comparison 37. 12.5% DL‐α‐tocopherol (vitamin E) versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean reduction of lesion counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 37. 12.5% DL‐α‐tocopherol (vitamin E) versus placebo
Comparison 38. Etretinate versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 38. Etretinate versus placebo
Comparison 39. Carbon dioxide laser resurfacing versus 5% 5‐FU

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean percentage of reduction of lesion counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

2 Withdrawal due to adverse events Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 39. Carbon dioxide laser resurfacing versus 5% 5‐FU
Comparison 40. Carbon dioxide laser resurfacing versus Trichloroacetic acid peel

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean percentage of reduction of lesion counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

2 Withdrawal due to adverse events Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 40. Carbon dioxide laser resurfacing versus Trichloroacetic acid peel
Comparison 41. Er:YAG laser resurfacing versus 5% 5‐FU

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean reduction in lesion counts Show forest plot

Other data

No numeric data

2 Mean percentage of reduction in lesion counts Show forest plot

Other data

No numeric data

3 Withdrawal due to adverse events Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

4 Skin irritation Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

4.1 At the end of treatment

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4.2 At 3 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4.3 At 6 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

5 Minor adverse events excluding skin irritation: dermatology: acne Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

5.1 At 3 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

5.2 At 6 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

5.3 At 12 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6 Minor adverse events excluding skin irritation: dermatology:crustea Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

6.1 At the end of treatment

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.2 At 3 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.3 At 6 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.4 At 12 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7 Minor adverse events excluding skin irritation: dermatology: infection Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

7.1 At the end of treatment

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8 Minor adverse events excluding skin irritation: dermatology: milia Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

8.1 At 3 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.2 At 6 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8.3 At 12 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9 Minor adverse events excluding skin irritation: dermatology:pain Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

9.1 At the end of treatment

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9.2 At 3 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10 Cosmetic outcomes: changes in pigmentation (hypo) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

10.1 At 3 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.2 At 6 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10.3 At 12 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

11 Cosmetic outcomes: scarring Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

11.1 At 3 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

11.2 At 12 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

12 Cosmetic outcomes: improvement in photoageing score Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

12.1 At 3 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

12.2 At 6 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

12.3 At 12 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figuras y tablas -
Comparison 41. Er:YAG laser resurfacing versus 5% 5‐FU
Comparison 42. Cryotherapy versus betulin‐based oleogel

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2 Participant partial (>75%) clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 42. Cryotherapy versus betulin‐based oleogel
Comparison 43. Cryotherapy versus 5% 5‐FU

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

1.1 After treatment

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 At 12 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Cosmetic outcomes: excellent global cosmetic outcome Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

3 Cosmetic outcomes: better skin appearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 43. Cryotherapy versus 5% 5‐FU
Comparison 44. Cryotherapy versus imiquimod

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

1.1 5% imiquimod

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Cosmetic outcomes: excellent global cosmetic outcome Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

3 Cosmetic outcomes: better skin appearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 44. Cryotherapy versus imiquimod
Comparison 45. Cryotherapy versus MAL‐red light PDT

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean percentage of reduction in lesion counts Show forest plot

Other data

No numeric data

2 Withdrawal due to adverse events Show forest plot

2

379

Risk Ratio (M‐H, Random, 95% CI)

1.06 [0.16, 7.16]

3 Cosmetic outcomes: excellent or good cosmetic outcomes by investigator Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

4 Cosmetic outcomes: excellent or good cosmetic outcomes by participant Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

Figuras y tablas -
Comparison 45. Cryotherapy versus MAL‐red light PDT
Comparison 46. Cryotherapy versus ALA‐red light PDT

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2 Skin irritation Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2.1 During treatment

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 One day after treatment

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figuras y tablas -
Comparison 46. Cryotherapy versus ALA‐red light PDT
Comparison 47. ALA‐PDT versus placebo‐PDT

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance [1 treatment] Show forest plot

4

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

1.1 Blue light

1

243

Risk Ratio (M‐H, Random, 95% CI)

6.22 [2.88, 13.43]

1.2 Red light

3

422

Risk Ratio (M‐H, Random, 95% CI)

5.94 [3.35, 10.54]

2 Participant complete clearance [1 or 2 treatments] Show forest plot

2

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2.1 Blue light

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 Red light

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3 Participant complete clearance [1 or 2 treatments] by anatomical location Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

3.1 Face

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3.2 Scalp

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4 Participant partial (> 75%) clearance [1 treatment] Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

4.1 Blue light

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

5 Participant partial (>75%) clearance[1 or 2 treatments] Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

5.1 Blue light

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6 Participant partial (>75%) clearance [1 or 2 treatment] by anatomical location Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

6.1 Face

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.2 Scalp

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7 Skin irritation Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

7.1 Red light‐during illumination

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.2 Red light‐after treatment

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8 Minor adverse events excluding skin irritation: body as a whole: injury Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

8.1 Blue light

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

9 Minor adverse events excluding skin irritation: cardiovascular: hypertension Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

9.1 Blue light

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10 Minor adverse events excluding skin irritation: dermatology: skin discolouration Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

10.1 Red light

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

11 Minor adverse events excluding skin irritation: dermatology: skin hypertrophy Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

11.1 Blue light

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

12 Minor adverse events excluding skin irritation: nervous system: headache Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

12.1 Blue light

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

13 Cosmetic outcome: very good or good general cosmetic outcome Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 47. ALA‐PDT versus placebo‐PDT
Comparison 48. ALA‐ blue light PDT versus ALA‐pulsed laser PDT

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2 Participant partial (>75%) clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

3 Cosmetic outcome: improvement in global response Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

4 Cosmetic outcome: improvement in tactile roughness Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

5 Cosmetic outcome: improvement in mottled hyperpigmentation Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 48. ALA‐ blue light PDT versus ALA‐pulsed laser PDT
Comparison 49. ALA‐red light PDT at different application times

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance at 4 weeks Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

1.1 0.5h versus 1.0h

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 0.5h versus 2 h

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 0.5h versus 4h

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.4 1h versus 2h

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.5 1h versus 4h

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.6 2h versus 4h

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Participant complete clearance at 8 weeks Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2.1 0.5h versus 1.0h

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 0.5h versus 2 h

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.3 0.5h versus 4h

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.4 1h versus 2h

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.5 1h versus 4h

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.6 2h versus 4h

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3 Minor adverse events excluding skin irritation: metabolic and nutritional disorders: elevated alanine transaminase (ALT) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

3.1 0.5h versus 1.0h

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3.2 0.5h versus 2 h

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3.3 0.5h versus 4h

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4 Minor adverse events excluding skin irritation: nervous system: headache Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

4.1 0.5h versus 1h

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4.2 0.5h versus 2h

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4.3 0.5h versus 4h

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4.4 1h versus 2h

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4.5 1h versus 4h

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4.6 2h versus 4h

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

5 Minor adverse events excluding skin irritation: other: epistaxis (nose bleeding) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

5.1 0.5h versus 4h

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

5.2 1h versus 4h

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

5.3 2h versus 4h

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figuras y tablas -
Comparison 49. ALA‐red light PDT at different application times
Comparison 50. ALA‐PDT versus 0.5% 5‐FU

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

1.1 Blue light

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 Pulsed dye laser

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 Combined

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Participant partial (>75%) clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2.1 Blue light

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 Pulsed dye laser

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.3 Combined

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3 Withdrawal due to adverse events Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

3.1 Blue light

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3.2 Pulsed dye laser

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3.3 Combined

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4 Cosmetic outcome: improvement in global response Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

4.1 Blue light

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4.2 Pulsed dye laser

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4.3 Combined

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

5 Cosmetic outcome: improvement in tactile roughness Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

5.1 Blue light

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

5.2 Pulsed dye laser

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

5.3 Combined

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6 Cosmetic outcome: improvement in mottled hyperpigmentation Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

6.1 Blue light

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.2 Pulsed dye laser

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.3 Combined

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figuras y tablas -
Comparison 50. ALA‐PDT versus 0.5% 5‐FU
Comparison 51. ALA‐red light PDT vs cryotherapy

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2 Skin irritation Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2.1 During treatment

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 One day after treatment

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figuras y tablas -
Comparison 51. ALA‐red light PDT vs cryotherapy
Comparison 52. MAL‐red light PDT versus placebo‐red light PDT

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

5

482

Risk Ratio (M‐H, Random, 95% CI)

4.46 [3.17, 6.28]

2 Participant partial (>75%) clearance Show forest plot

2

191

Risk Ratio (M‐H, Random, 95% CI)

3.28 [1.73, 6.23]

3 Withdrawal due to adverse events Show forest plot

2

191

Risk Ratio (M‐H, Random, 95% CI)

2.00 [0.23, 17.74]

4 Minor adverse event: nervous system: headache Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

5 Cosmetic outcome: hyperpigmentation Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 52. MAL‐red light PDT versus placebo‐red light PDT
Comparison 53. MAL‐red light LED PDT versus MAL‐broad visible + water‐filtered infrared A PDT (1 or 2 treatments)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

1.1 At 3 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 At 6 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 At 12 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Participant partial (>75%) clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2.1 At 3 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 At 6 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.3 At 12 months

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figuras y tablas -
Comparison 53. MAL‐red light LED PDT versus MAL‐broad visible + water‐filtered infrared A PDT (1 or 2 treatments)
Comparison 54. MAL‐red light LED PDT versus MAL‐daylight PDT

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean reduction in lesion counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 54. MAL‐red light LED PDT versus MAL‐daylight PDT
Comparison 55. 2h MAL‐day light PDT versus 3h MAL‐daylight PDT

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean reduction in lesion counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

2 Mean percentage of reduction in lesion counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 55. 2h MAL‐day light PDT versus 3h MAL‐daylight PDT
Comparison 56. 16% MAL‐daylight PDT versus 8% MAL‐daylight PDT

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean reduction in lesion counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 56. 16% MAL‐daylight PDT versus 8% MAL‐daylight PDT
Comparison 57. Single MAL‐red light PDT versus multiple MAL‐red light PDT (2 treatments 1 week apart)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2 Withdrawal due to adverse events Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 57. Single MAL‐red light PDT versus multiple MAL‐red light PDT (2 treatments 1 week apart)
Comparison 58. MAL‐ red light PDT vs cryotherapy

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Withdrawal due to adverse events Show forest plot

2

379

Risk Ratio (M‐H, Random, 95% CI)

0.94 [0.14, 6.36]

Figuras y tablas -
Comparison 58. MAL‐ red light PDT vs cryotherapy
Comparison 59. ALA‐red light PDT versus MAL‐red light PDT

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean reduction in lesion counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 59. ALA‐red light PDT versus MAL‐red light PDT
Comparison 60. Trichloroacetic acid peel versus 5% 5‐FU

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean percentage of reduction in lesions Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 60. Trichloroacetic acid peel versus 5% 5‐FU
Comparison 61. Cryotherapy versus cryotherapy with betulin‐based oleogel

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2 Participant partial (>75%) clearance Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 61. Cryotherapy versus cryotherapy with betulin‐based oleogel
Comparison 62. (0.5% 5‐FU + cryotherapy) versus (vehicle + cryotherapy)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance at 6 months Show forest plot

2

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

1.1 1 cycle (1 week topical, cryosurgery at week 4, follow‐up at 6 months)

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 2 cycles ( 1 week topical, cryosurgery at week 4, follow‐up at 6 months)

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 3 cycles ( 1 week topical, cryosurgery at week 4, follow‐up at 6 months)

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Mean reduction in lesion counts at 6 months Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2.1 1 cycle (1 week topical, cryosurgery at week 4, follow‐up at 6 months)

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.2 2 cycles ( 1 week topical, cryosurgery at week 4, follow‐up at 6 months)

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.3 3 cycles ( 1 week topical, cryosurgery at week 4, follow‐up at 6 months)

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 Mean percentage of reduction in lesion counts at 6 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3.1 1 cycle (1 week topical, cryosurgery at 4 weeks, follow‐up at 6 months)

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 Minor adverse events excluding skin irritation: body as a whole: allergic reaction Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

5 Minor adverse events excluding skin irritation: dermatology: hyperesthesia Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

6 Minor adverse events excluding skin irritation: dermatology: skin discoloration Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

7 Minor adverse events excluding skin irritation: dermatology: vesiculobullous rash Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

8 Minor adverse events excluding skin irritation: digestive: cheilitis Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

9 Minor adverse events excluding skin irritation: special senses: conjunctivitis Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

10 Minor adverse events excluding skin irritation: special senses: eye irritation Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 62. (0.5% 5‐FU + cryotherapy) versus (vehicle + cryotherapy)
Comparison 63. (vehicle + cryotherapy) versus (0.5% 5‐FU + cryotherapy)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance at 6 months Show forest plot

2

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

1.1 1 cycle (1 week topical, cryosurgery at week 4, follow‐up at 6 months)

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 2 cycles ( 1 week topical, cryosurgery at week 4, follow‐up at 6 months)

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 3 cycles ( 1 week topical, cryosurgery at week 4, follow‐up at 6 months)

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Mean reduction in lesion counts at 6 months Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2.1 1 cycle (1 week topical, cryosurgery at week 4, follow‐up at 6 months)

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.2 2 cycles ( 1 week topical, cryosurgery at week 4, follow‐up at 6 months)

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.3 3 cycles ( 1 week topical, cryosurgery at week 4, follow‐up at 6 months)

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 Mean percentage of reduction in lesion counts at 6 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3.1 1 cycle (1 week topical, cryosurgery at 4 weeks, follow‐up at 6 months)

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

Figuras y tablas -
Comparison 63. (vehicle + cryotherapy) versus (0.5% 5‐FU + cryotherapy)
Comparison 64. Cryotherapy with vehicle versus cryotherapy with imiquimod

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance of all lesions Show forest plot

2

311

Risk Ratio (M‐H, Random, 95% CI)

0.20 [0.05, 0.73]

1.1 5% imiquimod

1

64

Risk Ratio (M‐H, Random, 95% CI)

0.40 [0.11, 1.42]

1.2 3.75% imiquimod

1

247

Risk Ratio (M‐H, Random, 95% CI)

0.11 [0.04, 0.30]

2 Participant complete clearance of target (cryotherapy treated) lesions Show forest plot

2

311

Risk Ratio (M‐H, Random, 95% CI)

0.62 [0.36, 1.04]

2.1 5% imiquimod

1

64

Risk Ratio (M‐H, Random, 95% CI)

0.87 [0.47, 1.60]

2.2 3.75% imiquimod

1

247

Risk Ratio (M‐H, Random, 95% CI)

0.50 [0.37, 0.68]

3 Participant complete clearance of subclinical lesions Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

3.1 5% imiquimod

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4 Mean percentage of reduction in all lesion counts Show forest plot

2

301

Mean Difference (IV, Random, 95% CI)

‐23.69 [‐46.03, ‐1.34]

4.1 5% imquimod

1

54

Mean Difference (IV, Random, 95% CI)

‐11.20 [‐26.53, 4.13]

4.2 3.75% imiquimod

1

247

Mean Difference (IV, Random, 95% CI)

‐34.10 [‐41.38, ‐26.82]

5 Mean percentage of reduction in target (cryotherapy treated) lesion counts Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

5.1 3.75% imiquimod

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

6 Withdrawal due to adverse events Show forest plot

2

312

Risk Ratio (M‐H, Random, 95% CI)

0.93 [0.28, 3.07]

6.1 5% imiquimod

1

65

Risk Ratio (M‐H, Random, 95% CI)

2.91 [0.12, 68.95]

6.2 3.75% imiquimod

1

247

Risk Ratio (M‐H, Random, 95% CI)

0.77 [0.21, 2.79]

7 Skin irritation Show forest plot

2

311

Risk Ratio (M‐H, Random, 95% CI)

0.39 [0.10, 1.54]

7.1 5% imiquimod

1

64

Risk Ratio (M‐H, Random, 95% CI)

0.63 [0.20, 2.01]

7.2 3.75% imiquimod

1

247

Risk Ratio (M‐H, Random, 95% CI)

0.15 [0.02, 1.19]

8 Minor adverse events excluding skin irritation: body as a whole: fatigue Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

9 Minor adverse events excluding skin irritation: digestive: nausea Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

10 Minor adverse events excluding skin irritation: musculoskeletal and connective tissue: myalgia Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

11 Minor adverse events excluding skin irritation: respiratory: upper respiratory tract infection Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

12 Minor adverse events excluding skin irritation: respiratory: bronchitis Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

13 Minor adverse events excluding skin irritation: respiratory: sinusitis Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

14 Minor adverse events excluding skin irritation: special senses: conjunctivitis Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

15 Cosmetic outcomes: Improved global photoageing score Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

16 Cosmetic outcomes: Improved fine lines Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

17 Cosmetic outcomes: Improved tactile roughness Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

18 Cosmetic outcomes: Improved mottled pigmentation Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

19 Cosmetic outcomes: Improved sallowness Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

20 Cosmetic outcomes: cosmetic appearance score Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

20.1 Investigator

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

20.2 Participant

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

Figuras y tablas -
Comparison 64. Cryotherapy with vehicle versus cryotherapy with imiquimod
Comparison 65. Cryotherapy with imiquimod versus cryotherapy with vehicle

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Participant complete clearance of all lesions Show forest plot

2

311

Risk Ratio (M‐H, Random, 95% CI)

5.04 [1.37, 18.51]

1.1 5% imiquimod

1

64

Risk Ratio (M‐H, Random, 95% CI)

2.48 [0.70, 8.76]

1.2 3.75% imiquimod

1

247

Risk Ratio (M‐H, Random, 95% CI)

9.12 [3.36, 24.79]

2 Mean percentage of reduction in all lesion counts Show forest plot

2

301

Mean Difference (IV, Random, 95% CI)

23.69 [1.34, 46.03]

2.1 5% imquimod

1

54

Mean Difference (IV, Random, 95% CI)

11.20 [‐4.13, 26.53]

2.2 3.75% imiquimod

1

247

Mean Difference (IV, Random, 95% CI)

34.10 [26.82, 41.38]

3 Withdrawal due to adverse events Show forest plot

2

312

Risk Ratio (M‐H, Random, 95% CI)

1.08 [0.33, 3.56]

3.1 5% imiquimod

1

65

Risk Ratio (M‐H, Random, 95% CI)

0.34 [0.01, 8.13]

3.2 3.75% imiquimod

1

247

Risk Ratio (M‐H, Random, 95% CI)

1.30 [0.36, 4.73]

4 Skin irritation Show forest plot

2

311

Risk Ratio (M‐H, Random, 95% CI)

2.55 [0.65, 10.04]

4.1 5% imiquimod

1

64

Risk Ratio (M‐H, Random, 95% CI)

1.60 [0.50, 5.13]

4.2 3.75% imiquimod

1

247

Risk Ratio (M‐H, Random, 95% CI)

6.72 [0.84, 53.83]

Figuras y tablas -
Comparison 65. Cryotherapy with imiquimod versus cryotherapy with vehicle
Comparison 66. (3% diclofenac in 2.5% hyaluronic acid + ALA‐red light PDT) versus (2.5% hyaluronic acid + ALA‐red light PDT)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Global Improvement Indices (‐2 to 4) at 6 months Show forest plot

Other data

No numeric data

2 Mean reduction of lesion counts Show forest plot

Other data

No numeric data

Figuras y tablas -
Comparison 66. (3% diclofenac in 2.5% hyaluronic acid + ALA‐red light PDT) versus (2.5% hyaluronic acid + ALA‐red light PDT)