Evidence map›Paper›PMID 28155090›Full record

SynthesisAmerican journal of clinical dermatology2017

Oral Spironolactone for Acne Vulgaris in Adult Females: A Hybrid Systematic Review.

Alison M Layton, E Anne Eady, Heather Whitehouse, James Q Del Rosso, Zbys Fedorowicz, Esther J van Zuuren

Open access · hybridAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in American journal of clinical dermatology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 4 pooled it
10.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 4 syntheses or guidelines pooled it, 119 citations in OpenAlex.

  1. Pooled it
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  10. Effects of mineralocorticoid receptor antagonists on sex hormones and body composition in patients with primary aldosteronism.Hypertension research : official journal of the Japanese Society of Hypertension · 2022
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  19. What's New After NICE Acne Guidelines.Dermatology and therapy · 2024
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 4 countries.

Alison M LaytonDepartment of Dermatology, Harrogate and District NHS Foundation Trust, Harrogate, HG2 7SX, UK.
E Anne EadyDepartment of Dermatology, Harrogate and District NHS Foundation Trust, Harrogate, HG2 7SX, UK. eaeady@gmail.com.
Heather WhitehouseDepartment of Dermatology, Harrogate and District NHS Foundation Trust, Harrogate, HG2 7SX, UK.
James Q Del RossoLakes Dermatology and Del Rosso Dermatology Research Center, Las Vegas, NV, USA.
Zbys FedorowiczCochrane Bahrain, Awali, Bahrain.
Esther J van ZuurenDepartment of Dermatology, Leiden University Medical Center, Leiden, The Netherlands.
Harrogate and District NHS Foundation Trust · GBDermatology Research Center · USLeiden University Medical Center · NLUniversity of Bahrain · BH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe management of acne in adult females is problematic, with many having a history of treatment failure and some having a predisposition to androgen excess. Alternatives to oral antibiotics and combined oral contraceptives (COCs) are required.

objectiveOur aim was to conduct a hybrid systematic review of the evidence for benefits and potential harms of oral spironolactone in the management of acne in adult females.

methodsThe review was conducted according to a previously published protocol. Three reviewers independently selected relevant studies from the search results, extracted data, assessed the risk of bias, and rated the quality of the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

resultsTen randomized controlled trials (RCTs) and 21 case series were retrieved. All trials were assessed as being at a 'high risk' of bias, and the quality of evidence was rated as low or very low for all outcomes. Apart from one crossover trial that demonstrated statistical superiority of a 200 mg daily dose versus inflamed lesions compared with placebo, data from the remaining trials were unhelpful in establishing the degree of efficacy of lower doses versus active comparators or placebo. Menstrual side effects were significantly more common with the 200 mg dose; frequency could be significantly reduced by concomitant use of a COC. Pooling of results for serum potassium supported the recent recommendation that routine monitoring is not required in this patient population.

conclusionThis systematic review of RCTs and case series identified evidence of limited quality to underpin the expert endorsement of spironolactone at the doses typically used (≤100 mg/day) in everyday clinical practice.

Indexed as

Acne VulgarisAdministration, OralAdultAndrogensAnti-Bacterial AgentsContraceptives, Oral, CombinedFemaleHumansHyperandrogenismMineralocorticoid Receptor AntagonistsRandomized Controlled Trials as TopicSebaceous GlandsSpironolactoneTreatment FailureAndrogensAnti-Bacterial AgentsContraceptives, Oral, CombinedMineralocorticoid Receptor AntagonistsSpironolactone

Identifiers

PMID28155090
PMCPMC5360829
OpenAlexW2585329337

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.