PMID- 35453576
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2227-9059 (Print)
IS  - 2227-9059 (Electronic)
IS  - 2227-9059 (Linking)
VI  - 10
IP  - 4
DP  - 2022 Mar 31
TI  - Efficacy and Safety of Topical Mechanistic Target of Rapamycin Inhibitors for 
      Facial Angiofibromas in Patients with Tuberous Sclerosis Complex: A Systematic 
      Review and Network Meta-Analysis.
LID - 10.3390/biomedicines10040826 [doi]
LID - 826
AB  - Previous studies have suggested that the topical mechanistic target of rapamycin 
      (mTOR) inhibitors may be effective in treating facial angiofibromas in patients 
      with tuberous sclerosis complex (TSC). Various concentrations of topical 
      sirolimus for TSC have been tested, but their comparative efficacy and safety 
      remained unclear. To assess the effects of topical mTOR inhibitors in treating 
      facial angiofibromas, we conducted a systematic review and network meta-analysis 
      (NMA) and searched MEDLINE, Embase, and Cochrane Library for relevant randomized 
      controlled trials on 14 February 2022. The Cochrane Collaboration tool was used 
      to assess the risk of bias of included trials. Our outcomes were clinical 
      improvement and severe adverse events leading to withdrawal. We included three 
      trials on 261 TSC patients with facial angiofibromas. The NMA found when compared 
      with placebo, facial angiofibromas significantly improved following the 
      application of various concentrations of topical sirolimus (risk ratio being 
      3.87, 2.70, 4.43, and 3.34 for 0.05%, 0.1%, 0.2%, and 1%, respectively). When 
      compared with placebo, all concentrations of topical sirolimus did not differ in 
      severe adverse events leading to withdrawal. The ranking analysis suggested 
      topical sirolimus 0.2% as the most effective drug. In conclusion, topical 
      sirolimus 0.05-1% are effective and safe in treating facial angiofibromas in 
      patients with TSC, with topical sirolimus 0.2% being the most effective.
FAU - Lin, Yu-Ting
AU  - Lin YT
AUID- ORCID: 0000-0003-4658-1579
AD  - Department of Pharmacy, Chang Gung Memorial Hospital, Linkou, Taoyuan 33305, 
      Taiwan.
FAU - Yu, Chia-Ling
AU  - Yu CL
AUID- ORCID: 0000-0003-4471-8711
AD  - Department of Pharmacy, Chang Gung Memorial Hospital, Linkou, Taoyuan 33305, 
      Taiwan.
FAU - Tu, Yu-Kang
AU  - Tu YK
AUID- ORCID: 0000-0002-2461-474X
AD  - Institute of Epidemiology and Preventive Medicine, College of Public Health, 
      National Taiwan University, Taipei 10617, Taiwan.
FAU - Chi, Ching-Chi
AU  - Chi CC
AUID- ORCID: 0000-0001-5699-0283
AD  - Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan 33305, 
      Taiwan.
AD  - College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20220331
PL  - Switzerland
TA  - Biomedicines
JT  - Biomedicines
JID - 101691304
PMC - PMC9025300
OTO - NOTNLM
OT  - angiofibroma
OT  - mechanistic target of rapamycin (mTOR)
OT  - network meta-analysis
OT  - sirolimus
OT  - systematic review
OT  - tuberous sclerosis complex
COIS- The authors declare no conflict of interest.
EDAT- 2022/04/24 06:00
MHDA- 2022/04/24 06:01
PMCR- 2022/03/31
CRDT- 2022/04/23 01:01
PHST- 2022/03/04 00:00 [received]
PHST- 2022/03/30 00:00 [revised]
PHST- 2022/03/30 00:00 [accepted]
PHST- 2022/04/23 01:01 [entrez]
PHST- 2022/04/24 06:00 [pubmed]
PHST- 2022/04/24 06:01 [medline]
PHST- 2022/03/31 00:00 [pmc-release]
AID - biomedicines10040826 [pii]
AID - biomedicines-10-00826 [pii]
AID - 10.3390/biomedicines10040826 [doi]
PST - epublish
SO  - Biomedicines. 2022 Mar 31;10(4):826. doi: 10.3390/biomedicines10040826.