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NG198 Evidence Review E2

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NG198 Evidence Review E2 FINAL Management options for mild to moderate acne – pairwise comparisons Forest plots for review question: What is the effectiveness and acceptability of interventions for the treatment of mild to moderate acne (side effects and participant reported improvement)? This section includes forest plots only for outcomes that are meta-analysed. Outcomes from single studies are not presented here; the quality assessment for such outcomes is provided in the GRADE profiles in appendix F. Topical non-retinoids and retinoids Figure 2: Comparison of topical retinoid treatments with vehicle for the outcome of skin irritation ADAP: adapalene; ISO: isotretinoin; TRET: tretinoin Acne vulgaris: evidence reviews for management options for mild to moderate acne – pairwise comparisons FINAL (June 2021) 155 FINAL Management options for mild to moderate acne – pairwise comparisons Figure 3: Comparison of topical retinoid treatments with topical benzoyl peroxide treatment for the outcome of skin irritation ADAP: adapalene; BPO: benzoyl peroxide; ISO: isotretinoin Figure 4: Comparison of topical adapalene treatment with topical tretinoin treatment for the outcome of skin irritation ADAP: adapalene; TRET: tretinoin Figure 5: Comparison of topical adapalene treatment with topical clindamycin and benzoyl peroxide treatment for the outcome of skin irritation ADAP: adapalene; BPO: benzoyl peroxide; CLIN: clindamycin Acne vulgaris: evidence reviews for management options for mild to moderate acne – pairwise comparisons FINAL (June 2021) 156 FINAL Management options for mild to moderate acne – pairwise comparisons Figure 6: Comparison of topical retinoid treatment in combination with topical antibiotics with topical benzoyl peroxide treatment in combination with topical antibiotics for the outcome of skin irritation ADAP: adapalene; BPO: benzoyl peroxide; CLIN: clindamycin; ERYTH: erythromycin; ISO: isotretinoin Figure 7: Comparison of topical lower dose retinoid treatment with topical higher dose retinoid treatment for the outcome of skin irritation ADAP: adapalene; ISO: isotretinoin; TRET: tretinoin Own class topicals Figure 8: Comparison of topical azelaic acid with vehicle for the outcome of skin irritation AZE: azelaic acid Acne vulgaris: evidence reviews for management options for mild to moderate acne – pairwise comparisons FINAL (June 2021) 157 FINAL Management options for mild to moderate acne – pairwise comparisons Topical antibiotics Figure 9: Comparison of topical clindamycin with vehicle for the outcome of skin irritation CLIND: clindamycin Figure 10: Comparison of topical dapsone with vehicle for the outcome of skin irritation DAPS: dapsone Figure 11: Comparison of topical antibiotic with topical antibiotic for the outcome of skin irritation Acne vulgaris: evidence reviews for management options for mild to moderate acne – pairwise comparisons FINAL (June 2021) 158 FINAL Management options for mild to moderate acne – pairwise comparisons Figure 12: Comparison of topical antibiotic with topical antibiotic for the outcome of skin irritation AZE: azelaic acid; CLIND: clindamycin; ERYTH: erythromycin Topical antiseptics Figure 13: Comparison of topical benzoyl peroxide treatment with vehicle for the outcome of skin irritation BPO: benzoyl peroxide Topical acids No meta-analysis was conducted for topical acid treatments and so there are no forest plots. Oral antibiotics and combinations with other topicals No meta-analysis was conducted for oral antibiotic treatments and so there are no forest plots. Acne vulgaris: evidence reviews for management options for mild to moderate acne – pairwise comparisons FINAL (June 2021) 159 FINAL Management options for mild to moderate acne – pairwise comparisons Oral hormonal contraceptives or hormone-modifying agents Figure 14: Comparison of combined oral contraceptive treatment with placebo for the outcome of neurological side effect EE-oral + DROS-oral: ethhinylestradiol + drospirenone; EE-oral + DNG-oral: estradiol (valerate) + dienogest Figure 15: Comparison of combined oral contraceptive treatment with placebo for the outcome of breakthrough bleeding EE-oral + DROS-oral: ethhinylestradiol + drospirenone; EE-oral + LNG-oral: ethhinylestradiol + levonorgestrel Oral isotretinoin No meta-analysis was conducted for treatment with oral isotretinoin and so there are no forest plots. Acne vulgaris: evidence reviews for management options for mild to moderate acne – pairwise comparisons FINAL (June 2021) 160 FINAL Management options for mild to moderate acne – pairwise comparisons Physical treatments Chemical peels Figure 16: Comparison of salicylic acid peel treatment with Jessner’s peel treatment for the outcome of skin redness SAL: salicylic acid Energy based treatments (light/laser) No meta-analysis was conducted for energy based treatments and so there are no forest plots. Acne vulgaris: evidence reviews for management options for mild to moderate acne – pairwise comparisons FINAL (June 2021) 161 .
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