| Ketoconazole compared with ciclopirox for seborrhoeic dermatitis | ||||||
| Patient or population: patients with seborrhoeic dermatitis Intervention: ketoconazole Comparison: ciclopirox | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect(95% CI) | Number of participants(studies) | Quality of the evidence(GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Ciclopirox | Ketoconazole | |||||
| Failure to achieve complete resolution - Face only Clinical assessmentFollow-up: mean 4 weeks | Study population | RR 1.09 (0.95 to 1.26) | 447(3 studies) | ⊕⊕○○ Low a,b | ||
| 583 per 1000 | 636 per 1000 (554 to 735) | |||||
| Moderate | ||||||
| 630 per 1000 | 687 per 1000 (598 to 794) | |||||
| Failure to achieve complete resolution (long term) - Face only Clinical assessmentFollow-up: mean 4 weeks | Study population | RR 1.16 (0.98 to 1.38) | 339(2 studies) | ⊕⊕○○ Low a,c | ||
| 566 per 1000 | 657 per 1000 (555 to 782) | |||||
| Moderate | ||||||
| 710 per 1000 | 824 per 1000 (696 to 980) | |||||
| Side effects - Scalp only Self reportedFollow-up: mean 4 weeks | Study population | RR 1.35 (0.54 to 3.38) | 603(2 studies) | ⊕○○○ Very low a,d,e | ||
| 125 per 1000 | 169 per 1000 (68 to 423) | |||||
| Moderate | ||||||
| 124 per 1000 | 167 per 1000 (67 to 419) | |||||
| *The basis for the assumed risk (e.g. median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio. | ||||||
| GRADE Working Group grades of evidence. High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
a
Downgraded 1 level because most studies had high or unclear risk of bias.
b
Downgraded 1 level because of lack of precision: 272 participants. CI overlaps with RR = 1 and RR = 1.25.
c
Downgraded 1 level because of lack of precision: RR overlaps with 1 and with 1.25. N = 339 participants.
d
Downgraded 1 level because of heterogeneity: I² = 62%; 1 study shows no difference and 1 study favours ciclopirox.
e
Downgraded 1 level because of lack of precision: wide confidence interval overlapping with 1 and 1.25 and 0.75.