Why carry out this study?

Clinicians and healthcare payers have a multitude of options for treating moderate-to-severe plaque psoriasis, and network meta-analysis (NMA), a method by which multiple interventions can be compared simultaneously in a single analysis, has been used widely to support decision making based on the best available evidence of efficacy and safety.

Despite the widespread application of NMA to synthesize randomized evidence in psoriasis, skepticism around its use and mistrust of its results persist.

To address these concerns, we performed a systematic review of published NMAs assessing biologic therapies for moderate-to-severe psoriasis, aiming to assess the methodological quality of these analyses and explore differences in their results.

What was learned from the study?

Twenty-five NMAs have been published since 2006 and most have come to broadly similar results and conclusions, considering the available data when they were performed.

The most useful NMAs for clinical decision making are those that: include all relevant trials of comparator treatments, assessed in a way that reflects their marketing authorization and expected use in clinical practice; provide a thorough assessment of heterogeneity and inconsistency; and report comparative effects and associated uncertainty in a comprehensive manner.