Efficacy and tolerability of intralesional bleomycin in dermatology: A systematic review
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Efficacy and tolerability of intralesional bleomycin in dermatology : A systematic review. / Bik, Liora; Sangers, Tobias; Greveling, Karin; Prens, Errol; Haedersdal, Merete; van Doorn, Martijn.
In: Journal of the American Academy of Dermatology, Vol. 83, No. 3, 2020, p. 888-903.Research output: Contribution to journal › Review › Research › peer-review
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TY - JOUR
T1 - Efficacy and tolerability of intralesional bleomycin in dermatology
T2 - A systematic review
AU - Bik, Liora
AU - Sangers, Tobias
AU - Greveling, Karin
AU - Prens, Errol
AU - Haedersdal, Merete
AU - van Doorn, Martijn
PY - 2020
Y1 - 2020
N2 - Bleomycin is widely used as an off-label treatment for various dermatologic indications. However, a much-needed critical appraisal of the currently available evidence is lacking. We therefore evaluated the quality of clinical evidence for the efficacy and safety of intralesional bleomycin treatment for dermatologic indications with the aim to provide evidence-based recommendations for clinical practice. The PubMed, Embase, Medline Ovid, Web of Science, Cochrane Central, and Google Scholar databases were systematically searched. Two authors independently selected relevant studies according to predefined inclusion and exclusion criteria. We assessed the methodologic quality with the Cochrane Collaboration risk-of-bias assessment tool and selected 10 randomized clinical trials and 15 clinical controlled trials. Treatment indications included common warts, nonmelanoma skin cancer, cutaneous metastases, keloid and hypertrophic scars, and hemangioma. Intralesional bleomycin treatment showed significantly higher cure rates for warts compared with other treatments. Local adverse events included erythema, blackening, eschar formation, and superficial ulceration. None of the studies reported systemic adverse events. Methodologic quality of the studies was generally low. Consequently, no firm recommendations can be made for intralesional bleomycin treatment in clinical practice. However, this review suggests that intralesional bleomycin is a successful and well-tolerated treatment for recalcitrant warts.
AB - Bleomycin is widely used as an off-label treatment for various dermatologic indications. However, a much-needed critical appraisal of the currently available evidence is lacking. We therefore evaluated the quality of clinical evidence for the efficacy and safety of intralesional bleomycin treatment for dermatologic indications with the aim to provide evidence-based recommendations for clinical practice. The PubMed, Embase, Medline Ovid, Web of Science, Cochrane Central, and Google Scholar databases were systematically searched. Two authors independently selected relevant studies according to predefined inclusion and exclusion criteria. We assessed the methodologic quality with the Cochrane Collaboration risk-of-bias assessment tool and selected 10 randomized clinical trials and 15 clinical controlled trials. Treatment indications included common warts, nonmelanoma skin cancer, cutaneous metastases, keloid and hypertrophic scars, and hemangioma. Intralesional bleomycin treatment showed significantly higher cure rates for warts compared with other treatments. Local adverse events included erythema, blackening, eschar formation, and superficial ulceration. None of the studies reported systemic adverse events. Methodologic quality of the studies was generally low. Consequently, no firm recommendations can be made for intralesional bleomycin treatment in clinical practice. However, this review suggests that intralesional bleomycin is a successful and well-tolerated treatment for recalcitrant warts.
KW - bleomycin
KW - cutaneous metastases
KW - dermatology
KW - drug response
KW - efficacy
KW - electrochemotherapy
KW - hemangioma
KW - hypertrophic scars
KW - intralesional
KW - keloid
KW - nonmelanoma skin cancer
KW - safety
KW - systematic review
U2 - 10.1016/j.jaad.2020.02.018
DO - 10.1016/j.jaad.2020.02.018
M3 - Review
C2 - 32068046
AN - SCOPUS:85082421028
VL - 83
SP - 888
EP - 903
JO - American Academy of Dermatology. Journal
JF - American Academy of Dermatology. Journal
SN - 0190-9622
IS - 3
ER -
ID: 260690935