Summary of findings 8. Alitretinoin compared to placebo for chronic palmoplantar pustulosis.
| Alitretinoin compared to placebo for chronic palmoplantar pustulosis | ||||||
| Patient or population: chronic palmoplantar pustulosis Setting: not reported Intervention: alitretinoin Comparison: placebo | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | No. of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with placebo | Risk with alitretinoin | |||||
| Proportion of participants cleared or almost cleared ‐ not reported | ‐ | ‐ | ‐ | ‐ | ‐ | Not reported |
| Proportion of participants with adverse effects serious or severe enough to have caused withdrawal ‐ not reported | ‐ | ‐ | ‐ | ‐ | ‐ | Not reported |
| Proportion of participants with at least 50% improvement in their quality of life ‐ not reported | ‐ | ‐ | ‐ | ‐ | ‐ | Not reported |
| Proportion of participants achieving a 50% reduction in disease severity in the long term (24 weeks) | Study population | RR 0.69 (0.36 to 1.30) | 33 (1 RCT) | ⊕⊕⊕⊝ Moderatea | ‐ | |
| 667 per 1000 | 460 per 1000 (240 to 867) | |||||
| Proportion of participants without relapse in the long term ‐ not reported | ‐ | ‐ | ‐ | ‐ | ‐ | Not reported |
| Proportion of participants with adverse effects ‐ measured over 24 weeks | Study population | RR 0.84 (0.61 to 1.17) | 33 (1 RCT) | ⊕⊕⊕⊝ Moderatea | Adverse effects in the alitretinoin group included headache, nasopharyngitis, cheilitis, nausea, arthralgia, and hypercholesterolaemia. | |
| 889 per 1000 | 747 per 1000 (542 to 1000) | |||||
| Ease of compliance to an intervention or a treatment ‐ not reported | ‐ | ‐ | ‐ | ‐ | ‐ | Not reported |
| *The risk in the intervention group (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; RCT: randomised controlled trial; RR: risk ratio. | ||||||
| GRADE Working Group grades of evidence. High quality: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate quality: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low quality: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low quality: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
aDowngraded by one level to moderate‐quality evidence because this comparison was assessed in only one trial involving 33 participants (imprecision).