Summary of findings 7. Injectable fillers versus placebo or no treatment for acne scars.
| Injectable fillers versus placebo or no treatment for acne scars | ||||||
| Patient or population: people with acne scars Settings: outpatient Intervention: injectable fillers versus placebo or no treatment | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | Injectable fillers versus placebo or no treatment | |||||
| Participant‐assessed scar improvement (long‐term) | See comment | See comment | Not estimable | ‐ | See comment | This outcome was not measured |
| Participant‐reported scar improvement (short‐term) N of participants with > 50% improvement in acne scars Follow‐up: mean 6 months | 420 per 1000 | 773 per 1000 (550 to 1000) | RR 1.84 (1.31 to 2.59) | 147 (1 study) | ⊕⊕⊕⊝ moderate1 | Munavalli 2013 reported 43% vs 18% improvement with the dermal filler and placebo respectively |
| Participant satisfaction N of satisfied participants Follow‐up: mean 6 months | 520 per 1000 | 848 per 1000 (640 to 1000) | RR 1.63 (1.23 to 2.15) | 147 (1 study) | ⊕⊕⊕⊝ moderate1 | ‐ |
| Participant‐reported adverse events (short‐term) N of participants with positive adverse events Follow‐up: mean 4 weeks | 20 per 1000 | 21 per 1000 (2 to 222) | RR 1.03 (0.1 to 11.1) | 147 (1 study) | ⊕⊕⊝⊝ low2 | ‐ |
| Investigator‐assessed adverse events (short‐term) N of participants with positive adverse events Follow‐up: mean 4 weeks | 260 per 1000 | 174 per 1000 (94 to 330) | RR 0.67 (0.36 to 1.27) | 147 (1 study) | ⊕⊕⊝⊝ low3 | Munavalli 2013 reported comparable incidence of events with dermal filler and placebo |
| Quality of life | See comment | See comment | Not estimable | ‐ | See comment | This outcome was not measured |
| *The basis for the assumed risk (e.g. the 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. | ||||||
1Downgraded one level for imprecision because the optimal information size (OIS) is not met (should be around 300), although the sample size is not that small. 2Downgraded two levels for very serious imprecision because the optimal information size (OIS) is not met (should be around 1500), small sample size, and the 95% CI around the estimate of effect includes both no effect and appreciable harm. 3Downgraded two levels for very serious imprecision because the optimal information size (OIS) is not met, and the 95% CI around the estimate of effect includes both no effect and appreciable harm.