原发性多汗症治疗的系统性循证综述。

IF 2.4
Michael E Stuart, Sheri A Strite, Kristin Khalaf Gillard
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引用次数: 9

摘要

目的:多汗症(过度出汗)与显著的生活质量负担相关,但往往治疗不足。由于有限的fda批准的治疗方法,医疗保健提供者必须在批准和标签外选择中确定最佳治疗方法。本综述的主要目的是重新评估、更新和扩展先前对原发性多汗症常用治疗方案的系统综述,包括考虑铝和锆化合物。方法:我们对干预措施的有效性、健康相关生活质量、满意度和安全性进行了定性系统评价,复制和扩展了之前系统评价中概述的策略,并增加了利用患者内设计的研究。我们对已确定的研究进行了批判性评估,以确定偏倚风险(RoB)和证据强度(SOE)。结果:共有32项研究符合批判性评价标准。只有3项研究被评为“低”RoB,分别是2项glycopyronium布(2.4%)临床试验和1项A型肉毒杆菌毒素注射治疗腋下多汗症的试验;在治疗腋窝多汗症时,两者的SOE评分均为“中等”,这是本综述中最高的评分。结论:最佳治疗选择取决于几个因素,包括了解每种治疗的疗效和安全性的证据质量(便利性和成本的考虑超出了本综述的范围)。在多汗症,如在其他临床条件下,治疗决定应以病人为中心。目前,由于证据质量的原因,本综述中对多汗症治疗的效果只能进行不精确的估计,并且不可能对比较效果进行陈述。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

A systematic evidence-based review of treatments for primary hyperhidrosis.

A systematic evidence-based review of treatments for primary hyperhidrosis.

A systematic evidence-based review of treatments for primary hyperhidrosis.

A systematic evidence-based review of treatments for primary hyperhidrosis.

Objective: Hyperhidrosis (excessive sweating) is associated with significant quality-of-life burden yet is often undertreated. With limited FDA-approved treatments, health care providers must determine optimal treatment among approved and off-label options. Key objectives of this review were to reassess, update, and expand a previous systematic review of commonly used treatment options for primary hyperhidrosis, including consideration of aluminum and zirconium compounds.

Methods: We performed a qualitative systematic review of efficacy, health-related quality of life, satisfaction, and safety of interventions, replicating and expanding the strategy outlined in a previous systematic review, with the addition of studies utilizing a within-patient design. We performed a critical appraisal of identified studies to determine risk of bias (RoB) and strength of evidence (SOE).

Results: A total of 32 studies were eligible for critical appraisal. Only three studies - two clinical trials of glycopyrronium cloth (2.4%) and one trial of botulinum toxin A injections in axillary hyperhidrosis were rated as "low" RoB; both had SOE ratings of "moderate" for use in axillary hyperhidrosis - the highest rating included in this review.

Conclusions: Optimal treatment choice depends on several factors, including understanding the quality of evidence regarding each treatment's efficacy and safety (considerations of convenience and cost are beyond the scope of this review). In hyperhidrosis, as in other clinical conditions, treatment decisions should be patient centered. At this time, because of the quality of evidence, only imprecise estimates of effect are possible for hyperhidrosis treatments included in this review, and statements about comparative effectiveness are not possible.

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来源期刊
Journal of Drug Assessment
Journal of Drug Assessment PHARMACOLOGY & PHARMACY-
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