Comparative efficacy of intralesional therapies for keloid scars: a network meta-analysis - PubMed
4 hours ago
- #keloid-treatment
- #intralesional-therapies
- #meta-analysis
- Keloids cause pain, pruritus, and emotional distress, with emerging treatments like insulin and botulinum toxin A (BTX-A) needing more comparative analysis.
- A network meta-analysis (NMA) evaluated 23 intralesional therapies across 51 studies (3234 participants), focusing on efficacy, recurrence, and safety.
- 5-FU + corticoids significantly improved keloid reduction compared to corticoids alone (RR = 1.59; p < 0.01), with 5-FU + corticoids + YAG:Laser showing even greater effect (RR = 2.73; p < 0.01).
- SUCRA rankings indicated 5-FU + corticoids + YAG:Laser (0.95), vitamin D + platelet-rich plasma (0.83), and 5-FU + corticoids (0.78) as most effective.
- No significant differences in recurrence rates were found across interventions, suggesting insufficient evidence.
- BTX-A (RR = 0.29; p = 0.04) and Verapamil (RR = 0.35; p = 0.01) showed significant risk reduction in adverse effects compared to corticoids.
- Combination therapies, especially 5-FU + corticoids + YAG:Laser, offer the greatest benefit, but further research is needed for novel agents like insulin and BTX-A.