Publications by authors named "Cleach L"

Objectives: To explore the association between industry funding and network meta-analyses' (NMAs) conclusion, and the use in Clinical Practice Guidelines (CPGs) of NMAs.

Study Design And Setting: This was an overview of NMAs and CPGs. We searched PubMed/MEDLINE, Epistemonikos, and several guideline databases up to February 18th 2023.

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Objectives: Incomplete reporting of safety outcomes in quality and availability of safety reporting in published articles of randomized controlled trials (RCTs) were described in different medical areas. The number of RCTs assessing systemic treatments for psoriasis has increased considerably. Complete and precise reporting of safety is mandatory for the efficacy/harms balance evaluation.

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Article Synopsis
  • Psoriasis is a chronic immune-mediated disease affecting skin and/or joints, significantly impacting quality of life, with no known cure but manageable through various treatments.
  • This study aimed to evaluate and rank the effectiveness and safety of non-biological systemic agents, small molecules, and biologics for moderate-to-severe psoriasis using a network meta-analysis approach.
  • Researchers analyzed data from randomized controlled trials, focusing on the percentage of participants achieving nearly clear skin and the occurrence of serious side effects, to determine the relative benefits and harms of different treatment options.
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Cutaneous lichen planus is a highly pruritic dermatosis with an unmet need in its management. The aim of this study was to evaluate the short-term effect and tolerance of high doses of clobetasol propionate 0.05% in cutaneous lichen planus.

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Article Synopsis
  • - Psoriasis is a chronic disease with symptoms affecting the skin and joints, significantly lowering quality of life; while no cure exists, various treatment options help manage symptoms.
  • - This study aims to evaluate the efficacy and safety of different psoriasis treatments (including systemic agents and biologics) through a network meta-analysis to determine their effectiveness and rank them accordingly.
  • - The researchers reviewed randomized controlled trials involving adults with moderate-to-severe psoriasis, focusing on outcomes like skin improvement and serious adverse events to assess treatment effectiveness and safety.
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Importance: A clear dosing regimen for methotrexate in psoriasis is lacking, and this might lead to a suboptimal treatment. Because methotrexate is affordable and globally available, a uniform dosing regimen could potentially optimize the treatment of patients with psoriasis worldwide.

Objective: To reach international consensus among psoriasis experts on a uniform dosing regimen for treatment with methotrexate in adult and pediatric patients with psoriasis and identify potential future research topics.

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Background: Network meta-analyses (NMAs) have become successful in addressing gaps in the comparative effectiveness of systemic treatments in moderate-to-severe psoriasis. However, their increasing number carries both a risk of overlap and reproducibility issues that can hamper clinical decision-making.

Objectives: In this overview, we aimed to assess redundancy across these NMAs and to describe their characteristics.

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Importance: Erythema multiforme (EM) may become long term, with a recurrent or persistent course. First-line treatment for chronic EM is valaciclovir. There is no consensus for selection of second-line treatment of chronic EM.

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Article Synopsis
  • Psoriasis is a chronic immune-mediated disease that affects the skin and joints, significantly impacting quality of life, and while no cure exists, various treatments can manage the symptoms.
  • This study aimed to conduct a network meta-analysis comparing the efficacy and safety of different treatment options (non-biological systemic agents, small molecules, and biologics) for moderate-to-severe psoriasis.
  • The researchers reviewed numerous randomized controlled trials (RCTs) and focused on outcomes such as achieving clear skin, using established criteria like the Psoriasis Area and Severity Index (PASI).
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Background: The availability of effective treatments for psoriasis raises ethical questions about the use of a placebo group in therapeutic trials. We evaluated the use of the placebo over time in such trials.

Methods: From trials in a living Cochrane review and network meta-analysis for psoriasis, we included trials comparing a biologic to a placebo or other systemic treatment.

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Background: Palmoplantar pustulosis (PPP) is a chronic inflammatory disease in which sterile and relapsing pustules appear on the palms and soles.

Objectives: To assess the effects of interventions for chronic PPP to induce and maintain complete remission.

Methods: We searched for randomized controlled trials (RCTs), including people with PPP or chronic palmoplantar pustular psoriasis, in the Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase, LILACS and eight trials registers up to July 2020.

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Background: Acral lesions, mainly chilblains, are the most frequently reported cutaneous lesions associated with COVID-19. In more than 80% of patients tested, nasopharyngeal swabs were negative on reverse transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2 when performed, and serology was generally not performed.

Methods: A national survey was launched on 30 March 2020 by the French Society of Dermatology asking physicians to report cases of skin manifestations in patients with suspected or confirmed COVID-19 by using a standardized questionnaire.

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We sought to assess the quality of dermatological systematic reviews (SRs) and identify factors that predict high methodological quality. We searched for all SRs published in 2017 using PubMed, Epistemonikos, and the Cochrane Database of SRs. We included studies identified as SRs or meta-analysis in the title or abstract and dealing with a dermatological topic.

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Background: In reported systematic reviews and meta-analyses of randomized controlled trials (RCTs) assessing treatments for psoriasis, the proportion of serious adverse events (SAEs) did not differ between treatments and placebo. Including cases of psoriasis worsening as SAEs may explain the lack of difference.

Objectives: This systematic review and meta-analysis aimed to explore this possibility.

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Topical drugs are often used as first-line treatment for dermatological conditions. Depending on the disease and the drug, three main designs can be used for randomized controlled trials assessing topical drugs: the classical individual parallel design, the cluster randomized design, and designs allowing within-individual comparisons, including the cross-over design (in which patients are randomized to a sequence of interventions) and the within-person design (also called the split-body design). Within-person design can be used to compare different drugs concomitantly in the same patient.

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