A systematic review and meta-analysis of randomized clinical trials of fire needle combined with ALA-PDT for the treatment of moderate-to-severe acne

作者全名："Tang, Lei; Fu, Qiang; Zhou, Zi-wenyan; Liu, Lin; Huang, Mengya; Zheng, Qi; Huang, Fujun; Zhang, Miao; Zhou, Xun"

作者地址："[Tang, Lei; Liu, Lin; Huang, Mengya; Zhou, Xun] Chongqing Hosp Tradit Chinese Med, Dept Dermatol & Cosmetol, Chongqing, Peoples R China; [Fu, Qiang; Zheng, Qi; Huang, Fujun; Zhang, Miao] Chongqing Med Univ, Coll Tradit Chinese Med, Chongqing, Peoples R China; [Zhou, Zi-wenyan] Chongqing Med Univ, Chongqing, Peoples R China"

通信作者："Zhou, X (通讯作者)，Chongqing Hosp Tradit Chinese Med, Dept Dermatol & Cosmetol, Chongqing, Peoples R China."

来源：PHOTODIAGNOSIS AND PHOTODYNAMIC THERAPY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000949504300001

JCR分区：Q2

影响因子：3.1

年份：2023

卷号：42

期号：　

开始页：　

结束页：　

文献类型：Review

关键词：Moderate-to-severe acne; Acne; Fire needle; ALA-PDT; Meta-analysis

摘要："Background: Moderate-to-severe acne affects people's health and quality of life. As first-line therapeutic medications, isotretinoin and antibiotics are used to treat moderate-to-severe acne, but outcomes can be improved. The combination of fire needle and ALA-PDT may be one option. This study evaluated the safety and effectiveness in the treatment of moderate-to-severe acne by the combination with fire needle and ALA-PDT. Methods: By July 2022, search PubMed, the Chinese Biomedical Literature dababase, the Cochrane Library, the Chinese Scientific Journal Database, the China National Knowledge Infrastructure, the Web of Science Datebase, Embase Datebase,VIP Database and WanFang Database. To gather RCTs of the combination of fire needle and ALA-PDT for the treatment of moderate-to-severe acne. A meta-analysis was performed according to the Handbook guidelines of Cochrane. Study selection, data extraction, and risk of bias evaluation were all governed by two reviewers, with the help of a third reviewer if necessary. The meta-analysis was carried out with Review Manager Software 5.4. Results: There were a total of 9 RCTs with 862 participants. Clinical efficacy was recorded in nine trials, GAGS score was published in three studies, adverse events were documented in five studies, and the recurrence rate was reported in two studies. Treatment lasted between four and twelve weeks. Combination therapy outperformed monotherapy in terms of clinical efficacy (OR:3.73; 95% CI:2.51, 5.53; p < 0.00001). Additional subgroup analysis revealed that the combination therapy outperformed ALA-PDT alone in terms of clinical effect (OR: 3.20; 95% CI: 2.05, 4.99; p < 0.00001). Additionally, combination therapy outperformed fire needle alone in terms of clinical efficacy (OR:5.66; 95% CI: 2.66, 12.08; p < 0.00001). Studies have also indicated that combination therapy has a stronger benefit in lowering the GAGS score (MD:-3.35; 95% CI:-4.62,-2.09; p < 0.00001). Additionally, there was no discernible difference in the occurrence of adverse events between the combined treatments and monotherapy (OR:1.43; 95% CI: 0.76, 2.69; p = 0.26), and the combined treatment was able to control the recurrence rate (OR:0.18; 95% CI: 0.07, 0.45; P = 0.0002). Conclusions: The efficacy of fire needle combined with ALA-PDT in the treatment of moderate-to-severe acne appears superior to that of ALA-PDT or fire needle alone. However, the conclusions of this study must be interpreted carefully due to the high risk and ambiguity of bias of the included trials."

基金机构：Chongqing City Science and Tech- nology Plan Project [2021ZY023609]

基金资助正文：This study was supported by the Chongqing City Science and Tech- nology Plan Project (No. 2021ZY023609) .