PASI75 at 4-12weeks
12 articles reporting 14 RCTs comparing 9 treatment arms,including vehicle, tofacitinib, tapinarof, benvitimod, calcipotriol, roflumilast, Cal/BD, betamethasone, tacalcitol, halobetasol.The NMA showed that all treatments except tofacitinib performed significantly better than vehicle(Fig.2 and Supplemental table 2).We found that Cal/BD and tapinarof had higher rank probabilities (SUCRA 91.5and 84.1 respectively) in terms of PASI75,followed by roflumilast, betamethasone and benvitimod.
Safety oftopical therapies at 4–12 weeks
13 RCTs comparing among 11 treatments(including vehicle),according to the SUCRA, tofacitinib had lower AEs than Cal/BD(SUCRA 85 and 43.8 respectively), the highest probability for AEs was found with tapinarof(SUCRA 1.2),followed by benvitimod and HP/TAZ(Supplemental Table 4).Compared with vehicle,the highest odds of AEs were tapinarof(OR 3.50 95%CI2.71 to 4.52),benvitimod(OR 2.68 95%CI1.91 to 3.77) and HP/TAZ(OR 1.92 95%CI1.29 to 2.87), the lowest odds of AEs were tofacitinib(OR 0.85 95%CI0.57 to 1.27) and betamethasone(OR 0.89 95%CI0.62 to 1.29). (Table 1 and supplemental figure 3b ).
Tolerability of topical therapies at 4–12 weeks
We measured tolerability of drugs from withdrawal data due to adverse events.15 RCTs reported the tolerability by comparing 10 treatments. The highest odds of withdrawal were with tapinarof(OR 3.97 95%CI1.14 to 13.89) and benvitimod(OR 3.23 95%CI1.33 to 7.82) that compared with vehicle. (Supplemental Table 3).According to the SUCRA,the betamethasone and roflumilast had highest tolerability(SUCRA 86.3 and 83.3 respectively). (Supplemental Table 4)