Network meta-analyses in psoriasis: overview and critical discussion

Area of Science:

• Dermatology
• Evidence Synthesis
• Biostatistics

Background:

• Network meta-analyses (NMAs) are crucial for comparing multiple treatments in psoriasis.
• The growing number of drugs and clinical trials (CTs) necessitates robust NMAs.

Purpose of the Study:

• To characterize the methodology and reporting quality of NMAs published in the field of psoriasis.
• To identify trends in NMA design, included treatments, outcomes, and adherence to reporting standards.

Main Methods:

• A systematic literature search was conducted in PubMed using PRISMA criteria.
• Twenty-seven NMAs on psoriasis treatments were identified and analyzed for key characteristics.

Main Results:

• NMAs included an average of 43 CTs and 19,624 patients.
• Ustekinumab, adalimumab, infliximab, and etanercept were most frequently analyzed.
• Reporting on PROSPERO registration (29.6%) and PRISMA adherence (63%) was suboptimal.
• Psoriasis Area and Severity Index (PASI) 75 and 90 were common efficacy outcomes, with a focus on induction efficacy.

Conclusions:

• While NMAs in psoriasis demonstrate consistent efficacy findings, there are significant gaps in methodological reporting and adherence to established guidelines.
• Improved standardization of NMA methodology and reporting is essential for enhancing the reliability and utility of these studies for clinical decision-making.