Abstract
Background: Mucopolysaccharide polysulfate (MPS) cream as a moisturizer is widely applied to treat eczema, and a lot of clinical trials have demonstrated its efficacy and safety. However, there is no further research to collect and analyze these studies.Objective: This meta-analysis aimed to assess the efficacy and safety of MPS cream as monotherapy or add-on therapy for non-exudative eczema.Methods: Ten databases were searched to identify the eligible randomized controlled trials (RCTs) from their inception to July 31, 2021. Revman 5.3 software was used for the meta-analysis.Results: A total of eligible 20 studies were included. Among the 20 studies, 2 studies compared MPS cream with other moisturizers, 14 compared MPS cream plus topical corticosteroids (TCS) with TCS alone, and 4 compared with MPS cream plus tacrolimus ointment with tacrolimus ointment alone. The pooled results demonstrated that MPS cream had a higher total efficacy rate [Risk ratio (RR) 1.21, 95% CI: 1.12 to 1.30, P < 0.00001], a lower recurrence rate (RR 0.44, 95% CI: 0.26 to 0.74, P = 0.002) and a lower pruritus score [mean difference (MD) −1.78, 95% CI: −2.16 to −1.40, P < 0.00001] than urea cream or vaseline ointment. Moreover, in comparison with TCS or tacrolimus ointment alone, the combination treatment performed better in terms of total efficacy rate, total symptom score, recurrence rate, and pruritus score. For safety, the skin adverse events were mild, and MPS cream as monotherapy or add-on therapy did not increase the risk of skin adverse events.Conclusions: MPS cream as monotherapy or add-on therapy could provide a good effect for treating non-exudative eczema with mild and tolerable skin adverse events. However, due to the suboptimal quality of the included studies, high-quality and large-sample RCTs are needed in the future for update or validation.Systematic Review Registration: PROSPERO (https://www.crd.york.ac.uk/PROSPERO/), identifier: CRD42021265735.
Highlights
Eczema, known as atopic eczema or atopic dermatitis, is a common chronic skin disease characterized by itch and a wide spectrum of clinical signs, such as erythema, papules, vesicles, crust, lichenification, and dry skin [1]
The pooled results demonstrated that Mucopolysaccharide polysulfate (MPS) cream had a higher total efficacy rate [Risk ratio (RR) 1.21, 95% confidence interval (CI): 1.12 to 1.30, P < 0.00001], a lower recurrence rate (RR 0.44, 95% CI: 0.26 to 0.74, P = 0.002) and a lower pruritus score [mean difference (MD) −1.78, 95% CI: −2.16 to −1.40, P < 0.00001] than urea cream or vaseline ointment
The skin adverse events were mild, and MPS cream as monotherapy or add-on therapy did not increase the risk of skin adverse events
Summary
Known as atopic eczema or atopic dermatitis, is a common chronic skin disease characterized by itch and a wide spectrum of clinical signs, such as erythema, papules, vesicles, crust, lichenification, and dry skin [1]. The pathophysiology of eczema is complex and results from complex interactions between genetic and environmental factors. In many guidelines for the treatment of eczema, both topical corticosteroids (TCS) and topical calcineurin inhibitor (TCI), as anti-inflammatory treatments, are recommended to reduce skin inflammation, and oral antihistamines could be applied to relieve pruritus if necessary. Due to skin barrier dysfunction and dry skin in eczema patients, emollient therapy is important and basic. It could improve skin barrier function and reduce skin susceptibility to irritants. Mucopolysaccharide polysulfate (MPS) cream as a moisturizer is widely applied to treat eczema, and a lot of clinical trials have demonstrated its efficacy and safety. There is no further research to collect and analyze these studies
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