Abstract

Objective To evaluate existing drugs for the treatment and prevention of scars and keloids through network meta-analysis methods. Methods By searching the PubMed, Blackwell, Cochrane Central, Web of Science, Ovid, and Scopus database and the domestic Chinese Biomedical Literature Database, Wanfang database and the Chinese Journal Full-text Database database, literatures were retrieved relevant to the scar medication and prevention research, the data provided by the relevant documents into the Excel spreadsheet, and then import the spreadsheet into the R (2.15.1 version) software (http: //www.r-project.org/), the use of Meta software package and Q test for analysis. Results A total of 35 studies were included in the research which contained 28 literatures in English and 7 literatures in Chinese by database searches. Pooled analysis indicated that the drug′s effect on keloids treatment of the overall response rate was (80.0±3.0)%. The overall recurrence rate was (28.0±3.0)%. The effect size of the keloid treatment roughly in the order: steroids, bleomycin, 5-fluorouracil, mitomycin C, verapamil and collagenase. The OR for collagenase was less than 1, suggesting that it was ineffective and potentially harmful, and 95% CI of OR for 5-fluorouracil covered 1, thus its therapeutic effect had yet to be further confirmed. The recurrence ORs for adjuvant treatment of the drugs for keloids were: bleomycin, 5-fluorouracil, verapamil, hormone, imiquimod colchicine and tamoxifen. The drugs which confidence interval exceeds 50% were imiquimod, tamoxifen and verapamil. The comparison between the drugs for the treatment of keloid was not significant. As for the keloid adjuvant therapy, steroids and imiquimod were superior to other drugs in term of the recurrence rate whereas tamoxifen had the highest recurrence rate. Conclusions Options of drugs for keloid treatment: steroids, bleomycin, mitomycin C, and verapamil, while for the prevention of recurrence was steroids, the role of other drugs had yet to be confirmed. Key words: Meta-analysis; Cicatrix; Drug therapy; Prevention

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