4. Dropout rates from RCTs. Oral isotretinoin alone or in combination versus other active topical or systemic active therapy.
| Dropout rates | Study | Comparison | Estimate of effect: risk ratio, 95% CI | |
|
Intervention Number of participants who dropped out/Number of analysed participants |
Control Number of participants who dropped out/Number of analysed participants |
|||
| 1. Overall dropout rates | Gollnick 2001 |
Oral isotretinoin 0.5 to 0.8 mg/kg/day for 6 months* 2/35 |
Oral minocycline (50 mg twice daily) plus topical azelaic acid cream (twice daily) for 6 months 6/50 |
0.48 (0.10 to 2.22) |
| Oprica 2007 | Oral isotretinoin 1 mg/kg/day for 24 weeks 7/26 |
Tetracycline 500 mg twice daily plus topical adapalene 0.1% once a day for 24 weeks 6/26 |
1.17 (0.45 to 3.00) | |
| Strauss 2001 | Standard oral isotretinoin 0.85 to 1.18 mg/kg/day for 20 weeks 59/300 |
Micronised oral isotretinoin 0.32 to 0.4 mg/kg/day for 20 weeks 51/302 |
1.16 (0.83 to 1.63) | |
| Webster 2014 |
Standard oral isotretinoin, 0.5 mg/kg/day first 8 weeks, followed by 1 mg/kg/day until week 20 60/461 |
Isotretinoin‐Lidose, 1 mg/kg/day for 20 weeks 70/464 |
0.86 (0.63 to 1.19) | |
| Dhir 2008 | Oral isotretinoin 20 mg twice a day for 24 weeks 5/30 |
Oral isotretinoin 20 mg twice a day along with topical clindamycin (1%) during the daytime and adapalene (0.1%) at bedtime for 24 weeks 5/30 |
1.00 (0.26 to 3.89) | |
| Faghihi 2014 | Oral isotretinoin, 20 mg once a day plus vehicle neutral gel applied on the face twice daily, both for 8 weeks 0/29 |
Oral isotretinoin, 20 mg once a day plus 5% dapsone gel applied on the face twice daily, both for 8 weeks 0/29 |
Not estimable | |
| Lester 1985 |
Oral isotretinoin 1.0 to 2.0 mg/kg/day for 16 weeks 0/15 |
Oral tetracycline 0.5 to 1 g/day for 16 weeks 2/15 |
0.20 (0.01 to 3.85) | |
| Prendiville 1988 | Oral isotretinoin 40 mg daily for 16 weeks 3/20 |
Dapsone 100 mg daily for 16 weeks 3/20 |
1.00 (0.23 to 4.37) | |
| Tan 2014 |
Oral isotretinoin (0.5 mg/kg/day for the first 4 weeks with escalation to 1 mg/kg/day for subsequent 16 weeks) plus vehicle gel 17/133 |
Oral doxycycline 200 mg plus adapalene 0.1%/benzoyl peroxide 2.5% gel (both once daily) 28/133 |
0.61 (0.35 to 1.06) | |
| 2. Dropout rates due to improvement at 6 months | Oprica 2007 | Oral isotretinoin 1 mg/kg/day for 24 weeks 1/26 |
Tetracycline 500 mg twice daily plus topical adapalene 0.1% once a day for 24 weeks 0/26 |
3.00 (0.13 to 70.42) |
| 3. Dropout rates due to lack of efficacy | Gollnick 2001 |
Oral isotretinoin 0.5 to 0.8 mg/kg/day for 6 months 0/35 |
Oral minocycline (50 mg twice daily) plus topical azelaic acid cream (twice daily) for 6 months 1/50 |
0.47 (0.02 to 11.27) |
| 4. Dropout rates due to treatment failure | Lester 1985 |
Oral isotretinoin 1.0 to 2.0 mg/kg/day for 16 weeks 0/15 |
Oral tetracycline 0.5 to 1 g/day for 16 weeks 2/15 |
0.20 (0.01 to 3.85) |
| 5. Dropout rates, no improvement or worsening at 4 months | Oprica 2007 |
Oral isotretinoin 1 mg/kg/day for 24 weeks 0/26 |
Tetracycline 500 mg twice daily plus topical adapalene 0.1% once a day for 24 weeks 2/26 |
0.20 (0.01 to 3.97) |
| 6. Dropout rates due to adverse effects | Tan 2014 |
Oral isotretinoin (0.5 mg/kg/day for the first 4 weeks with escalation to 1 mg/kg/day for subsequent 16 weeks) plus vehicle gel 4/133 |
Oral doxycycline 200 mg plus adapalene 0.1%/benzoyl peroxide 2.5% gel (both once daily) 6/133 |
0.67 (0.19 to 2.31) |
| 7. Dropout rates due to adverse events | Strauss 2001 | Standard oral isotretinoin 0.85 to 1.18 mg/kg/day for 20 weeks 16/300 |
Micronised oral isotretinoin 0.32 to 0.4 mg/kg/day for 20 weeks 16/302 |
1.01 (0.51 to 1.98) |
| Webster 2014 |
Standard oral isotretinoin, 0.5 mg/kg/day first 8 weeks, followed by 1 mg/kg/day until week 20 15/461 |
Isotretinoin‐Lidose, 1 mg/kg/day for 20 weeks 19/464 |
0.79 (0.41 to 1.54) | |
| 8. Dropout rates due to adverse effects (local skin irritation) | Gollnick 2001 |
Oral isotretinoin 0.5 to 0.8 mg/kg/day for 6 months 0/35 |
Oral minocycline (50 mg twice daily) plus topical azelaic acid cream (twice daily) for 6 months 1/50 |
0.47 (0.02 to 11.27) |
| 9. Dropout rates due to adverse effects (gastric pain) | Gollnick 2001 |
Oral isotretinoin 0.5 to 0.8 mg/kg/day for 6 months 0/35 |
Oral minocycline (50 mg twice daily) plus topical azelaic acid cream (twice daily) for 6 months 1/50 |
0.47 (0.02 to 11.27) |
| 10. Dropout rates due to adverse effect (hypersensitivity reaction) | Prendiville 1988 |
Oral isotretinoin 40 mg daily for 16 weeks 0/20 |
Dapsone 100 mg daily for 16 weeks 1/20 |
0.33 (0.01 to 7.72) |
| 11. Dropout rates due to adverse effects (flare‐up) at 2 months | Oprica 2007 | Oral isotretinoin 1 mg/kg/day for 24 weeks 1/26 |
Tetracycline 500 mg twice daily plus topical adapalene 0.1% once a day for 24 weeks 0/26 |
3.00 (0.13 to 70.42) |
| 12. Dropout rates due to adverse effect (severe xerosis) at 4 months | Oprica 2007 | Oral isotretinoin 1 mg/kg/day for 24 weeks 2/26 |
Tetracycline 500 mg twice daily plus topical adapalene 0.1% once a day for 24 weeks 0/26 |
5.00 (0.25 to 99.34) |
| 13. Dropout rates due to adverse effect (gastrointestinal disturbances) at 4 months | Oprica 2007 |
Oral isotretinoin 1 mg/kg/day for 24 weeks 0/26 |
Tetracycline 500 mg twice daily plus topical adapalene 0.1% once a day for 24 weeks 1/26 |
0.33 (0.01 to 7.82) |
| 14. Dropout rates due to loss to follow‐up | Tan 2014 |
Oral isotretinoin (0.5 mg/kg/day for the first 4 weeks with escalation to 1 mg/kg/day for subsequent 16 weeks) plus vehicle gel 4/133 |
Oral doxycycline 200 mg plus adapalene 0.1%/benzoyl peroxide 2.5% gel (both once daily) 6/133 |
0.67 (0.19 to 2.31) |
| Webster 2014 |
Standard oral isotretinoin, 0.5 mg/kg/day first 8 weeks, followed by 1 mg/kg/day until week 20 60/461 |
Isotretinoin‐Lidose, 1 mg/kg/day for 20 weeks 70/464 |
0.81 (0.42 to 1.53) | |
| 15. Dropout rates due to poor compliance | Gollnick 2001 |
Oral isotretinoin 0.5 to 0.8 mg/kg/day for 6 months 1/35 |
Oral minocycline (50 mg twice daily) plus topical azelaic acid cream (twice daily) for 6 months 3/50 |
0.48 (0.05 to 4.39) |
| Webster 2014 | Standard oral isotretinoin, 0.5 mg/kg/day first 8 weeks, followed by 1 mg/kg/day until week 20 8/461 |
Isotretinoin‐Lidose, 1 mg/kg/day for 20 weeks 5/464 |
1.61 (0.53 to 4.89) | |
| 16. Dropout rates due to non‐attendance or poor compliance | Prendiville 1988 | Oral isotretinoin 40 mg daily for 16 weeks 3/20 |
Dapsone 100 mg daily for 16 weeks 1/20 |
3.00 (0.34 to 26.45) |
| 17. Dropout rates due to loss to follow‐up, refusal of treatment or violation of the protocol | Strauss 2001 | Standard oral isotretinoin 0.85 to 1.18 mg/kg/day for 20 weeks 43/300 |
Micronised oral isotretinoin 0.32 to 0.4 mg/kg/day for 20 weeks 35/302 |
1.24 (0.82 to 1.88) |
| 18. Dropout rates due to dissatisfaction with treatment | Prendiville 1988 |
Oral isotretinoin 40 mg daily for 16 weeks 0/20 |
Dapsone 100 mg daily for 16 weeks 1/20 |
0.33 (0.01 to 7.72) |
| 19. Dropout rates due to participant's request, withdrawal of consent | Tan 2014 |
Oral isotretinoin (0.5 mg/kg/day for the first 4 weeks with escalation to 1 mg/kg/day for subsequent 16 weeks) plus vehicle gel 3/133 |
Oral doxycycline 200 mg plus adapalene 0.1%/benzoyl peroxide 2.5% gel (both once daily) 8/133 |
0.38 (0.10 to 1.38) |
| Webster 2014 | Standard oral isotretinoin, 0.5 mg/kg/day first 8 weeks, followed by 1 mg/kg/day until week 20 15/461 |
Isotretinoin‐Lidose, 1 mg/kg/day for 20 weeks 15/464 |
1.01 (0.50 to 2.03) | |
| 20. Dropout rates due to other reasons (not specified) | Gollnick 2001 | Oral isotretinoin 0.5 to 0.8 mg/kg/day for 6 months 1/35 |
Oral minocycline (50 mg twice daily) plus topical azelaic acid cream (twice daily) for 6 months 0/50 |
4.25 (0.18 to 101.39) |
| Webster 2014 |
Standard oral isotretinoin, 0.5 mg/kg/day first 8 weeks, followed by 1 mg/kg/day until week 20 4/461 |
Isotretinoin‐Lidose, 1 mg/kg/day for 20 weeks 10/464 |
0.40 (0.13 to 1.27 | |
| 21. Dropout rates due to other reasons (not specified) at 2 months | Oprica 2007 | Oral isotretinoin 1 mg/kg/day for 24 weeks 1/26 |
Tetracycline 500 mg twice daily plus topical adapalene 0.1% once a day for 24 weeks 1/26 |
1.00 (0.07 to 15.15) |
| 22. Dropout rates due to other reasons (not specified) at 4 months | Oprica 2007 | Oral isotretinoin 1 mg/kg/day for 24 weeks 1/26 |
Tetracycline 500 mg twice daily plus topical adapalene 0.1% once a day for 24 weeks 0/26 |
3.00 (0.13 to 70.42) |
| 23. Dropout rates due to other reasons (not specified) at 6 months | Oprica 2007 |
Oral isotretinoin 1 mg/kg/day for 24 weeks 1/26 |
Tetracycline 500 mg twice daily plus topical adapalene 0.1% once a day for 24 weeks 2/26 |
0.50 (0.05 to 5.18) |
| 24. Dropout rates due to investigator's decision | Webster 2014 | Standard oral isotretinoin, 0.5 mg/kg/day first 8 weeks, followed by 1 mg/kg/day until week 20 2/461 |
Isotretinoin‐Lidose, 1 mg/kg/day for 20 weeks 1/464 |
2.01 (0.18 to 22.12) |
* The intervention groups which had lower dropout rates in each comparison are in bold.