Development of a core outcome set for clinical trials in melasma

Clinical trials of melasma are difficult to compare due to variation in the outcomes reported.

The purpose of this study was to develop a core set of outcome domains to be assessed in all clinical trials of melasma.

Identification of outcomes was performed via a literature review. Thereafter, 2 rounds of Delphi surveys were conducted, followed by consensus meetings to determine which outcomes should be in the final core domain set.

Seven core outcomes were recommended: relative intensity of representative area of pigmentation relative to baseline; color of dark spots; area and distribution of pigmentation; overall severity of melasma; patient satisfaction with treatment; quality of life; presence and severity of persistent versus transient treatment-related adverse events.

Hormonal and intrinsic vascular factors were not included in the core outcome set due to limited feasibility and lack of routine measurement as outcomes in clinical trials and in clinical practice. Additionally, there were very few Hispanic individuals in the Delphi group, although melasma is very common in Hispanic individuals.

A core outcome set has been developed for melasma trials. Routine use of this may improve comparability and pooling of data emanating from such trials.