Comparative Efficacy and Safety of Common Therapies in Keloids and Hypertrophic Scars: A Systematic Review and Meta-analysis
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At present, there are many therapies for treating keloids and hypertrophic scars, but there is still a lack of treatments that are relatively balanced in efficacy and safety. The study aims to evaluate comprehensively efficacy and safety of common therapies in keloids and hypertrophic scars.
The literature search was conducted up to May 2019. The traditional meta-analysis was performed on 17 therapies. Bayesian network meta-analysis was conducted on the four most common treatments. The outcome indicators were the numbers of patients with good-to-excellent effect, Vancouver Scar Scale (VSS) and adverse events.
There was no significant difference in the efficacy of triamcinolone acetonide (TAC) compared with other monotherapies except for silicone gel sheet and neodymium-yttrium-aluminum-garnet in primary indicator. The combination therapies were superior to TAC, and the results were consistent after the pooled analysis (RR = 0.522, 95% CI 0.332–0.823). The level of VSS in TAC group was higher than that in 5-flurouracil (5-FU) and TAC + 5-FU group, but lower than that in verapamil (VER) group. And the patients treated with TAC were less safe than those treated with verapamil (P = 0.013). Surface under cumulative ranking ranked verapamil and TAC + 5-FU as the favorable efficacy therapies in terms of primary indicator and ranked TAC + 5-FU as the best therapy for VSS, while VER was ranked as the worst.
This meta-analysis showed that TAC + 5-FU may be the most effective therapy, while verapamil may be a better therapeutic strategy for safety.
Level of Evidence III
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KeywordsKeloid Hypertrophic scar Treatment Meta-analysis
We thank all patients and healthy subjects who provided the information necessary for our study. We would like to acknowledgement the national natural science foundation of China and Scientific Research Foundation of Translational Medicine of Anhui Province for their financial support.
The study was sponsored by the National Natural Science Foundation of China (81273169,81573218 and 81773514) and Scientific Research Foundation of Translational Medicine of Anhui Province (2017zhyx03).
Compliance with Ethical Standards
Conflict of interest
All authors state that there is no conflict of interest.
For this type of study, informed consent is not required.
Statement of Human and Animal Rights, or Ethical Approval
This article does not contain any studies with human participants or animals performed by any of the authors.
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