Evidence map›Paper›PMID 39172296›Full record

SynthesisClinical drug investigation2024

Efficacy and Safety of Topical Roflumilast for the Treatment of Psoriasis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Rafaela de Moraes-Souza, Regina Chahine Chater, Izabela Pera Calvi, Yasmin Mesquita, Rubiana Sarto, Izadora Lapenda, Lívia Figueiredo Pereira, Luana Moury, Pedro Herranz-Pinto

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Clinical drug investigation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
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

7 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. PDE4 Inhibitor-Responsive Dermatoses: An Emerging Concept in Dermatology.The Journal of clinical and aesthetic dermatology · 2025
    Review
  5. Article
  6. Review
  7. Real-world safety profile of roflumilast: a pharmacovigilance analysis using FDA adverse event reporting system and Canada vigilance database.Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques · 2025
    Article
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

9 authors.

Rafaela de Moraes-SouzaDepartment of Dermatology, Faculty of Medicine, Autonomous University of Madrid, La Paz University Hospital, Madrid, Comunidad de Madrid, Spain.ORCID http://orcid.org/0000-0001-8637-3235
Regina Chahine ChaterDivision of Medicine, Albert Einstein Israeli Faculty of Health Sciences, São Paulo, São Paulo, Brazil.ORCID http://orcid.org/0009-0009-9646-8460
Izabela Pera CalviDivision of Medicine, Immanuel Kant Baltic Federal University, Kaliningrad, Kaliningrad Oblast, Russia.ORCID http://orcid.org/0000-0002-5448-8190
Yasmin MesquitaDivision of Medicine, Federal University of Rio de Janeiro, Macaé, Rio de Janeiro, Brazil.ORCID http://orcid.org/0000-0001-8607-6302
Rubiana SartoDivision of Medicine, Nevill Hall Hospital, Abergavenny, Monmouthshire, Wales.ORCID http://orcid.org/0009-0002-2215-3801
Izadora LapendaDivision of Medicine, Faculdade Pernambucana de Saúde, Recife, Pernambuco, Brazil.ORCID http://orcid.org/0000-0003-1972-3922
Lívia Figueiredo PereiraDivision of Medicine, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.ORCID http://orcid.org/0000-0002-6244-6687
Luana MouryDepartment of Dermatology, Mount Sinai Hospital, New York, New York State, USA.ORCID http://orcid.org/0000-0003-1014-0923
Pedro Herranz-PintoDepartment of Dermatology, Faculty of Medicine, Autonomous University of Madrid, La Paz University Hospital, Madrid, Comunidad de Madrid, Spain. pedro.herranz@uam.es.ORCID http://orcid.org/0000-0002-9840-6628

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivePlaque psoriasis is commonly treated topically with glucocorticoids and vitamin D derivatives. However, potential side effects such as skin atrophy underscore the need for safe and effective alternative topical therapies. Recently, the US Food and Drug Administration (FDA) and Health Canada approved roflumilast 0.3% cream as an option for treating this disease. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to assess the efficacy and safety of topical roflumilast 0.3% compared with vehicle for plaque psoriasis.

methodsPubMed, Embase, ClinicalTrials.gov, and Cochrane databases were searched from inception to 1 May 2024, assessing the outcomes of Investigator's Global Assessment (IGA) or body-IGA success (clear or almost clear status plus an at least 2-grade improvement from baseline), Psoriasis Area and Severity Index (PASI)-50, PASI-75, PASI-90, intertriginous-IGA success (clear or almost clear status on the intertriginous-IGA plus an at least 2-grade improvement from baseline), and adverse events (AEs). Statistical analysis was performed using Review Manager, R software, and RStudio. Heterogeneity was determined using the Cochran Q test and I

resultsFour RCTs were included, comprising a total of 1403 patients, of whom 885 (63.1%) received topical roflumilast 0.3% and 518 (36.9%) received vehicle. At week 8, the achievement of IGA or body-IGA success was significantly higher among those treated with topical roflumilast than in the vehicle group [relative risk (RR) 5.07; 95% confidence interval (CI) 3.55-7.23; p < 0.01]. Similar findings were observed at week 8 for PASI-50 (RR 2.73; 95% CI 2.27-3.29; p < 0.01), PASI-75 (RR 4.48; 95% CI 2.26-8.89; p < 0.01), and PASI-90 (RR 5.61; 95% CI 2.57-12.25; p < 0.01). Corresponding outcomes were found at weeks 2, 4, and 6. Additionally, a higher percentage of patients treated with topical roflumilast 0.3% once daily achieved intertriginous-IGA success, compared with those receiving vehicle, at week 8 (71.9% versus 20.5%; RR 3.32; 95% CI 2.11-5.22; p < 0.01), with similar findings at weeks 2, 4, and 6. While a significant difference was observed in the overall incidence of AEs between the topical roflumilast and vehicle groups, there was no difference in treatment-related AEs, serious AEs, or AEs leading to study discontinuation.

conclusionThese findings support the superiority of topical roflumilast 0.3% over vehicle and suggest its use as a valuable asset for the treatment of plaque psoriasis. PROTOCOL REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO), CRD42023456494.

Indexed as

AminopyridinesBenzamidesPsoriasisAdministration, TopicalCyclopropanesHumansPhosphodiesterase 4 InhibitorsRandomized Controlled Trials as TopicTreatment OutcomeAminopyridinesBenzamidesCyclopropanesPhosphodiesterase 4 InhibitorsRoflumilast

Identifiers

PMID39172296
PMCPMC11455807

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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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.