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Clin Exp Dermatol. 2009 Jan;34(1):20-5. doi: 10.1111/j.1365-2230.2008.02789.x. Epub 2008 Sep 25.

A systematic review of randomized controlled trials of treatments for inherited forms of epidermolysis bullosa.

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  • 1Centre of Evidence-based Dermatology, University of Nottingham, Nottingham, UK. sinead.langan@nottingham.ac.uk

Abstract

BACKGROUND:

Many interventions have been described for inherited epidermolysis bullosa (EB), but it is unclear which are beneficial.

AIMS:

A systematic review of randomized controlled trials (RCTs) was performed to inform practice and highlight research gaps.

METHODS:

The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and the Cochrane Skin Group specialist library, from inception until 1 April 2007, were searched. Primary outcomes were healing of lesions or prevention of new lesions. Trials were assessed for quality of reporting and data were extracted.

RESULTS:

Five randomized double-blind placebo-controlled crossover studies were identified (n = 102). Two studies assessed oral tetracyclines in EB simplex (EBS). In one study (n = 12), 4/6 patients improved and 2/6 deteriorated on a dose of 1500 mg of tetracycline daily; only two patients completed the study. In the second study (n = 21), 6/18 and 7/18 improved on oxytetracycline 1 g and placebo, respectively. Two RCTs assessed topical interventions for EBS: aluminium chloride hexahydrate solution 20% (n = 23) and bufexamac cream 5% (n = 8). Neither showed a benefit over placebo. One RCT of 36 patients with recessive dystrophic EB compared phenytoin with placebo and failed to show any difference in mean lesion counts (difference = 0, 95% CI -11 to 4).

CONCLUSIONS:

There is no reliable trial evidence for interventions in inherited EB. In future, it may be that gene treatment becomes the best treatment approach for these diseases.

PMID:
18828848
[PubMed - indexed for MEDLINE]
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