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Pediatric Surgery International

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01-08-2021 | Mometasone | Original Article

Topical corticosteroids for phimosis in children: a network meta-analysis of randomized clinical trials

Authors: Kannan Sridharan, Gowri Sivaramakrishnan

Published in: Pediatric Surgery International | Issue 8/2021

Abstract

Background

Corticosteroids and hyaluronidase are trialed for treating phimosis in children. We carried out the present network meta-analysis to compare the therapeutic effect of these drugs.

Methods

Electronic databases were searched for appropriate randomized clinical trials. Odds ratio (OR) with 95% confidence intervals (95% CI) was used as the effect estimate. A random-effects model was used for generating the pooled estimates. Rankogram plot was used for ranking the drugs.

Main outcome measures

Proportions of patients with remission (partial/complete) and with complete remission.

Results

Mometasone (OR 6.53, 95% CI 2.85, 14.96), betamethasone/hyaluronidase (OR 12.1, 95% CI 4.27, 34.49), triamcinolone (OR 19.15, 95% CI 4.47, 81.96), dexamethasone (OR 21.38, 95% CI 5.71, 79.98), betamethasone (OR 23.02, 95% CI 6.92, 79.54), hydrocortisone (OR 23.2, 95% CI 5.91, 91.02) and methylprednisolone (OR 50.47, 95% CI 4.45, 572.72) were observed with significantly higher proportions of patients with remission (partial/complete) compared to placebo. Dexamethasone, triamcinolone, betamethasone, betamethasone/hyaluronidase, clobetasol, mometasone, and hydrocortisone were observed with significantly higher proportions of patients with complete remission compared to placebo. Beclomethasone was not observed to be superior to either placebo or other drugs. Rankogram plot revealed methylprednisolone followed by hydrocortisone had the maximum statistical probability of being ‘the best’ in the pool for remission and betamethasone followed by hydrocortisone for complete remission.

Conclusion

Topical methylprednisolone, hydrocortisone, and betamethasone were observed with better clinical resolution of phimosis compared to other corticosteroids. Very high potent corticosteroids like beclomethasone and clobetasol were not observed with superior benefits compared to other corticosteroids. Considering low-potency, hydrocortisone shall be preferred until further evidence emerges.

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Title: Topical corticosteroids for phimosis in children: a network meta-analysis of randomized clinical trials
Authors: Kannan Sridharan
Gowri Sivaramakrishnan
Publication date: 01-08-2021
Publisher: Springer Berlin Heidelberg
Keywords: Mometasone
Phimosis
Dexamethasone
Published in: Pediatric Surgery International / Issue 8/2021
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-021-04906-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Topical corticosteroids for phimosis in children: a network meta-analysis of randomized clinical trials

Abstract

Background

Methods

Main outcome measures

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Main outcome measures

Results

Conclusion

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