Cochrane · systematic review · CD002292
Interventions for bullous pemphigoid
Singh, S, Kirtschig, G, Anchan, VN, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
SkinAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
24
current version
GRADE rated
19
No studies
5
Included studies
NR
No studies 5 · 20.8%Ungraded 0 · 0%Very low 9 · 37.5%Low 4 · 16.7%Moderate 4 · 16.7%High 2 · 8.3%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Clobetasol propionate cream compared to oral prednisone for bullous pemphigoid
Population: bullous pemphigoid
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Disease control (healing of skin lesions) at day 21 Clobetasol propionate cream vs oral prednisone | RR 1.08 [1.03, 1.13] | 1 study · 341 participants | Moderate Downgraded: risk of bias |
Mortality at 1 year Clobetasol propionate cream vs oral prednisone | RR 0.73 [0.53, 1.01] | 1 study · 341 participants | Low Downgraded: risk of bias, imprecision |
Quality of life ‐ not measured Clobetasol propionate cream vs oral prednisone | no estimate extracted | NR | No studies |
Adverse events: severe complications at day 21 Clobetasol propionate cream vs oral prednisone | RR 0.65 [0.5, 0.86] | 1 study · 341 participants | Low Downgraded: risk of bias, imprecision |
Mild clobetasol propionate cream regimen (10 to 30 g/day) compared to standard clobetasol propionate cream regimen (40 g/day)
Population: bullous pemphigoid
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Disease control (healing of skin lesions) at day 21. Intention‐to‐treat analysis, all participants Mild clobetasol propionate cream regimen (10 to 30 g/day) vs standard clobetasol propionate cream regimen (40 g/day) | RR 1 [0.97, 1.03] | 1 study · 312 participants | Moderate Downgraded: risk of bias |
Mortality at 1 year Mild clobetasol propionate cream regimen (10 to 30 g/day) vs standard clobetasol propionate cream regimen (40 g/day) | RR 1 [0.75, 1.32] | 1 study · 312 participants | Low Downgraded: risk of bias, imprecision |
Quality of life ‐ not measured Mild clobetasol propionate cream regimen (10 to 30 g/day) vs standard clobetasol propionate cream regimen (40 g/day) | no estimate extracted | NR | No studies |
Adverse events at 1 year Mild clobetasol propionate cream regimen (10 to 30 g/day) vs standard clobetasol propionate cream regimen (40 g/day) | RR 0.94 [0.78, 1.14] | 1 study · 309 participants | Low Downgraded: risk of bias, imprecision |
Doxycycline compared to prednisolone for bullous pemphigoid
Population: bullous pemphigoid
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Disease control at 6 weeks (unadjusted raw data) Doxycycline vs prednisolone | RR 0.81 [0.72, 0.92] | 1 study · 213 participants | High |
Treatment‐related mortality at 1 year (mITT) Doxycycline vs prednisolone | RR 0.25 [0.07, 0.89] | 1 study · 234 participants | Moderate Downgraded: imprecision |
Quality of life (DLQI) adjusted for baseline DLQI, disease severity, age, Karnovsky score, baseline versus week 52. A lower score is more favourable. Doxycycline vs prednisolone | no estimate extracted | 1 study · 234 participants | High |
Number of participants with grade 3‐4 (severe or life‐threatening) treatment‐related adverse events at 1 year (raw data) Doxycycline vs prednisolone | RR 0.59 [0.35, 0.99] | 1 study · 234 participants | Moderate Downgraded: imprecision |
Prednisone plus azathioprine compared to prednisone for bullous pemphigoid
Population: bullous pemphigoid
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Disease control (at 6 months) Prednisone plus azathioprine vs prednisone | RR 0.93 [0.52, 1.66] | 1 study · 67 participants | Very low Downgraded: risk of bias, imprecision |
Mortality (at 6 months) Prednisone plus azathioprine vs prednisone | RR 1.03 [0.35, 3.06] | 1 study · 67 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life ‐ not measured Prednisone plus azathioprine vs prednisone | no estimate extracted | NR | No studies |
Adverse events Prednisone plus azathioprine vs prednisone | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Nicotinamide plus tetracycline compared to prednisone for bullous pemphigoid
Population: bullous pemphigoid
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Disease control: complete response at 8 weeks: excluding dropouts Nicotinamide plus tetracycline vs prednisone | RR 2.5 [0.37, 16.89] | 1 study · 18 participants | Very low Downgraded: risk of bias, imprecision |
Mortality at 6 months Nicotinamide plus tetracycline vs prednisone | RR 0.18 [0.01, 3.85] | 1 study · 18 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life ‐ not measured Nicotinamide plus tetracycline vs prednisone | no estimate extracted | NR | No studies |
Adverse events at 1 year Nicotinamide plus tetracycline vs prednisone | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Methylprednisolone plus azathioprine compared to methylprednisolone plus dapsone for bullous pemphigoid
Population: bullous pemphigoid
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Disease control (time when steroid could be discontinued) Methylprednisolone plus azathioprine vs methylprednisolone plus dapsone | no estimate extracted | 1 study · 54 participants | Very low Downgraded: risk of bias, imprecision |
Mortality at 1 year Methylprednisolone plus azathioprine vs methylprednisolone plus dapsone | RR 0.33 [0.04, 3.01] | 1 study · 54 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life ‐ not measured Methylprednisolone plus azathioprine vs methylprednisolone plus dapsone | no estimate extracted | NR | No studies |
Adverse events at 1 year Methylprednisolone plus azathioprine vs methylprednisolone plus dapsone | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |