Combined oral contraceptive pills for treatment of acne.


BACKGROUND:Acne is a common skin disorder among women. Although no uniform approach to the management of acne exists, combination oral contraceptives (COCs), which contain an estrogen and a progestin, often are prescribed for women. OBJECTIVES:To determine the effectiveness of combined oral contraceptives (COCs) for the treatment of facial acne compared to placebo or other active therapies. SEARCH METHODS:In January 2012, we searched for randomized controlled trials of COCs and acne in the computerized databases of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, POPLINE, and LILACS. We also searched for clinical trials in and the International Clinical Trials Registry Platform (ICTRP) (Aug 2011). For the initial review, we wrote to researchers to seek any unpublished or published trials that we might have missed. SELECTION CRITERIA:We considered randomized controlled trials reported in any language that compared the effectiveness of a COC containing an estrogen and a progestin to placebo or another active therapy for acne in women. DATA COLLECTION AND ANALYSIS:We extracted data on facial lesion counts, both total and specific (i.e., open or closed comedones, papules, pustules and nodules); acne severity grades; global assessments by the clinician or the participant, and discontinuation due to adverse events. Data were entered and analyzed in RevMan. For continuous data, we calculated the mean difference (MD) and 95% confidence interval (CI). For dichotomous data, we calculated the Peto odds ratio (OR) and 95% CI. MAIN RESULTS:The review includes 31 trials with 12,579 participants. Of 24 comparisons made, 6 compared a COC to placebo, 17 different COCs, and 1 compared a COC to an antibiotic. Of nine placebo-controlled trials with data for analysis, all showed COCs reduced acne lesion counts, severity grades and self-assessed acne compared to placebo. A levonorgestrel-COC group had fewer total lesion counts (MD -9.98; 95% CI -16.51 to -3.45), inflammatory and non-inflammatory lesion counts, and were more likely to have a clinician assessment of clear or almost clear lesions and participant self-assessment of improved acne lesions. A norethindrone acetate COC had better results for clinician global assessment of no acne to mild acne (OR 1.86; 95% CI 1.32 to 2.62). In two combined trials, a norgestimate COC showed reduced total lesion counts (MD-9.32; 95% CI -14.19 to -4.45), reduced inflammatory lesion and comedones counts, and more with clinician assessment of improved acne. For two combined trials of a drospirenone COC, the investigators' assessment of clear or almost clear skin favored the drospirenone group (OR 3.02; 95% CI 1.99 to 4.59). In one trial, the drospirenone-COC group showed greater (more positive) percent changes for total lesion count (MD 29.08; 95% CI 3.13 to 55.03), inflammatory and non-inflammatory lesion counts, and papule and closed comedone counts. A dienogest-COC group had greater percentage decreases in total lesion count (MD -15.30; 95% CI -19.98 to -10.62) and inflammatory lesion count, and more women assessed with overall improvement of facial acne. A CMA-COC group had more 'responders,' those with 50% or greater decrease in facial papules and pustules (OR 2.31; 95% CI 1.50 to 3.55)Differences in the comparative effectiveness of COCs containing varying progestin types and dosages were less clear, and data were limited for any particular comparison. COCs that contained chlormadinone acetate or cyproterone acetate improved acne better than levonorgestrel. A COC with cyproterone acetate showed better acne outcomes than one with desogestrel, but the studies produced conflicting results. Likewise, levonorgestrel showed a slight improvement over desogestrel in acne outcomes, but results were not consistent. A drospirenone COC appeared to be more effective than norgestimate or nomegestrol acetate plus 17β-estradiol but less effective than cyproterone acetate. AUTHORS' CONCLUSIONS:This update yielded six new trials but no change in conclusions. The six COCs evaluated in placebo-controlled trials are effective in reducing inflammatory and non-inflammatory facial acne lesions. Few important and consistent differences were found between COC types in their effectiveness for treating acne. How COCs compare to alternative acne treatments is unknown since only one trial addressed this issue. The use of standardized methods for assessing acne severity would help in synthesizing results across trials as well as aid in interpretation.


Arowojolu AO,Gallo MF,Lopez LM,Grimes DA




Has Abstract


2012-07-11 00:00:00








  • Miniport versus standard ports for laparoscopic cholecystectomy.

    abstract:BACKGROUND:In conventional (standard) laparoscopic cholecystectomy, four abdominal ports (two of 10 mm diameter and two of 5 mm diameter) are used. Recently, use of smaller ports have been reported. OBJECTIVES:To assess the benefits and harms of miniport (defined as ports smaller than conventional ports) laparoscopic ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Gurusamy KS,Samraj K,Ramamoorthy R,Farouk M,Fusai G,Davidson BR

    更新日期:2010-03-17 00:00:00

  • Different communication strategies for disclosing a diagnosis of schizophrenia and related disorders.

    abstract:BACKGROUND:Delivering the diagnosis of a serious illness is an important skill in most fields of medicine, including mental health. Research has found that communication skills can impact on a person's recall and understanding of the diagnosis, treatment options and prognosis. People may feel confused and perplexed whe...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Farooq S,Johal RK,Ziff C,Naeem F

    更新日期:2017-10-24 00:00:00

  • Drugs for the treatment of nausea and vomiting in adults in the emergency department setting.

    abstract:BACKGROUND:Nausea and vomiting is a common and distressing presenting complaint in emergency departments (ED). The aetiology of nausea and vomiting in EDs is diverse and drugs are commonly prescribed. There is currently no consensus as to the optimum drug treatment of nausea and vomiting in the adult ED setting. OBJEC...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Furyk JS,Meek RA,Egerton-Warburton D

    更新日期:2015-09-28 00:00:00

  • Community wide interventions for increasing physical activity.

    abstract:BACKGROUND:Multi-strategic community wide interventions for physical activity are increasingly popular but their ability to achieve population level improvements is unknown. OBJECTIVES:To evaluate the effects of community wide, multi-strategic interventions upon population levels of physical activity. SEARCH METHODS:...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Baker PR,Francis DP,Soares J,Weightman AL,Foster C

    更新日期:2015-01-05 00:00:00

  • Maternal antigen avoidance during pregnancy for preventing atopic disease in infants of women at high risk.

    abstract:OBJECTIVES:To assess the effects of prescribing an antigen avoidance diet during pregnancy on the nutritional status of the mother and newborn and on the development of atopic disease in the child. The main focus is on women at high risk for giving birth to an atopic child, based on a history of atopic disease in the m...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Kramer MS

    更新日期:2000-01-01 00:00:00

  • Stent placement versus surgical palliation for adults with malignant gastric outlet obstruction.

    abstract:BACKGROUND:Malignant gastric outlet obstruction is the clinical and pathological consequence of cancerous disease causing a mechanical obstruction to gastric emptying. It usually occurs when malignancy is at an advanced stage; therefore, people have a limited life expectancy. It is of paramount importance to restore or...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Upchurch E,Ragusa M,Cirocchi R

    更新日期:2018-05-30 00:00:00

  • Combination contraceptives: effects on weight.

    abstract:BACKGROUND:Weight gain is often considered a side effect of combination hormonal contraceptives, and many women and clinicians believe that an association exists. Concern about weight gain can limit the use of this highly effective method of contraception by deterring the initiation of its use and causing early discont...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Gallo MF,Lopez LM,Grimes DA,Schulz KF,Helmerhorst FM

    更新日期:2006-01-25 00:00:00

  • Workplace interventions for reducing sitting at work.

    abstract:BACKGROUND:A large number of people are employed in sedentary occupations. Physical inactivity and excessive sitting at workplaces have been linked to increased risk of cardiovascular disease, obesity, and all-cause mortality. OBJECTIVES:To evaluate the effectiveness of workplace interventions to reduce sitting at wor...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析


    authors: Shrestha N,Kukkonen-Harjula KT,Verbeek JH,Ijaz S,Hermans V,Pedisic Z

    更新日期:2018-12-17 00:00:00

  • Motivational interviewing for alcohol misuse in young adults.

    abstract:BACKGROUND:Globally, harmful use of alcohol results in approximately 2.5 million deaths each year. About 9% of these deaths are young people between the ages of 15 and 29 years (WHO 2011), mainly resulting from motor vehicle accidents, homicides, suicides and drownings. Hazardous drinking levels for men (consuming over...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Foxcroft DR,Coombes L,Wood S,Allen D,Almeida Santimano NM

    更新日期:2014-08-21 00:00:00

  • Pre-admission antibiotics for suspected cases of meningococcal disease.

    abstract:BACKGROUND:Meningococcal disease begins suddenly and death can follow within hours. Pre-admission antibiotic therapy aims to prevent delay in starting therapy that occurs if bacterial confirmation is sought before instituting therapy. OBJECTIVES:To study the effectiveness and safety of pre-admission antibiotics versus...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Sudarsanam T,Rupali P,Tharyan P,Abraham OC,Thomas K

    更新日期:2008-01-23 00:00:00

  • Voxel-based morphometry for separation of schizophrenia from other types of psychosis in first episode psychosis.

    abstract:BACKGROUND:Schizophrenia is a psychiatric disorder which involves distortions in thought and perception, blunted affect, and behavioural disturbances. The longer psychosis goes unnoticed and untreated, the more severe the repercussions for relapse and recovery. There is some evidence that early intervention services ca...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Palaniyappan L,Maayan N,Bergman H,Davenport C,Adams CE,Soares-Weiser K

    更新日期:2015-08-07 00:00:00

  • Environmental sanitary interventions for preventing active trachoma.

    abstract:BACKGROUND:Trachoma is a major cause of avoidable blindness. It is responsible for about six million blind people worldwide, mostly in the poor communities of developing countries. One of the major strategies advocated for the control of the disease is the application of various environmental sanitary measures to such ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Rabiu M,Alhassan M,Ejere H

    更新日期:2007-10-17 00:00:00

  • Comparison of animal-derived surfactants for the prevention and treatment of respiratory distress syndrome in preterm infants.

    abstract:BACKGROUND:Animal-derived surfactants have been shown to have several advantages over the first generation synthetic surfactants and are the most commonly used surfactant preparations. The animal-derived surfactants in clinical use are minced or lavaged and modified or purified from bovine or porcine lungs. It is uncle...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Singh N,Halliday HL,Stevens TP,Suresh G,Soll R,Rojas-Reyes MX

    更新日期:2015-12-21 00:00:00

  • Oxygen therapy for lower respiratory tract infections in children between 3 months and 15 years of age.

    abstract:BACKGROUND:Treatment for lower respiratory tract infections (LRTIs) includes administering complementary oxygen. The effectiveness of oxygen therapy and of different delivery methods remains uncertain. OBJECTIVES:To determine the effectiveness and safety of oxygen therapy and oxygen delivery methods in the treatment o...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Rojas-Reyes MX,Granados Rugeles C,Charry-Anzola LP

    更新日期:2014-12-10 00:00:00

  • Hyperbaric oxygen therapy for chronic wounds.

    abstract:BACKGROUND:Chronic wounds are common and present a health problem with significant effect on quality of life. Various pathologies may cause tissue breakdown, including poor blood supply resulting in inadequate oxygenation of the wound bed. Hyperbaric oxygen therapy (HBOT) has been suggested to improve oxygen supply to ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Kranke P,Bennett MH,Martyn-St James M,Schnabel A,Debus SE,Weibel S

    更新日期:2015-06-24 00:00:00

  • Preoperative analgesics for additional pain relief in children and adolescents having dental treatment.

    abstract:BACKGROUND:Fear of dental pain is a major barrier to children needing dental care. The use of preoperative analgesics has the potential to reduce postoperative discomfort. In addition it might also reduce intraoperative pain. Reviewing the available evidence will determine whether further research is warranted and will...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Ashley PF,Parekh S,Moles DR,Anand P,Behbehani A

    更新日期:2012-09-12 00:00:00

  • Corticosteroids as adjunctive therapy in the treatment of influenza.

    abstract:BACKGROUND:Specific treatments for influenza are limited to neuraminidase inhibitors and adamantanes. Corticosteroids show evidence of benefit in sepsis and related conditions, most likely due to their anti-inflammatory and immunomodulatory properties. Although commonly prescribed for severe influenza, there is uncerta...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析


    authors: Lansbury L,Rodrigo C,Leonardi-Bee J,Nguyen-Van-Tam J,Lim WS

    更新日期:2019-02-24 00:00:00

  • Vitamin K supplementation for cystic fibrosis.

    abstract:BACKGROUND:Cystic fibrosis is a genetic disorder which can lead to multiorgan dysfunction. Malabsorption of fat and fat-soluble vitamins (A, D, E, K) may occur and can cause subclinical deficiencies of some of these vitamins. Vitamin K is known to play an important role in both blood coagulation and bone formation. Sup...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Jagannath VA,Fedorowicz Z,Thaker V,Chang AB

    更新日期:2011-01-19 00:00:00

  • Antibiotics for trachoma.

    abstract:BACKGROUND:Trachoma is the world's leading cause of preventable blindness. In 1997 the World Health Organization launched an initiative on trachoma control based on the 'SAFE' strategy (surgery, antibiotics, facial cleanliness and environmental improvement). OBJECTIVES:The aim of this review is to assess the evidence ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Mabey D,Fraser-Hurt N

    更新日期:2002-01-01 00:00:00

  • Therapeutic touch for healing acute wounds.

    abstract:BACKGROUND:Therapeutic Touch (TT) is an alternative therapy that has gained popularity over the past two decades for helping wounds to heal. Practitioners enter a meditative state and pass their hands above the patient's body to find and correct any imbalances in the patient's 'life energy' or chi. Scientific instrumen...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: O'Mathúna DP,Ashford RL

    更新日期:2012-06-13 00:00:00

  • Unconditional cash transfers for reducing poverty and vulnerabilities: effect on use of health services and health outcomes in low- and middle-income countries.

    abstract:BACKGROUND:Unconditional cash transfers (UCTs; provided without obligation) for reducing poverty and vulnerabilities (e.g. orphanhood, old age or HIV infection) are a type of social protection intervention that addresses a key social determinant of health (income) in low- and middle-income countries (LMICs). The relati...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Pega F,Liu SY,Walter S,Pabayo R,Saith R,Lhachimi SK

    更新日期:2017-11-15 00:00:00

  • Cognitive behaviour therapy for schizophrenia.

    abstract:BACKGROUND:Although medication is the mainstay of treatment for schizophrenia, always, some sort of informal or formal talking therapy is indicated. In cognitive behavioural therapy (CBT) links are made between the person's feelings and patterns of thinking which underpin their distress. OBJECTIVES:To review the effec...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Jones C,Cormac I,Mota J,Campbell C

    更新日期:2000-01-01 00:00:00

  • Heparin for prolonging peripheral intravenous catheter use in neonates.

    abstract:BACKGROUND:Peripheral intravenous (PIV) catheters are widely used in modern medical practice. However, mechanical or infectious complications often necessitate their removal and/or replacement. Heparin has been shown to be effective in prolonging the patency of peripheral arterial catheters and central venous catheters...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Shah PS,Ng E,Sinha AK

    更新日期:2005-10-19 00:00:00

  • Laparoscopic versus open surgical techniques for ventral or incisional hernia repair.

    abstract:BACKGROUND:There are many different techniques currently in use for ventral and incisional hernia repair. Laparoscopic techniques have become more common in recent years, although the evidence is sparse. OBJECTIVES:We compared laparoscopic with open repair in patients with (primary) ventral or incisional hernia. SEAR...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Sauerland S,Walgenbach M,Habermalz B,Seiler CM,Miserez M

    更新日期:2011-03-16 00:00:00

  • Postnatal parental education for optimizing infant general health and parent-infant relationships.

    abstract:BACKGROUND:Many learning needs arise in the early postpartum period and it is important to examine interventions being used to educate new parents about caring for themselves and their newborns during this time. OBJECTIVES:To assess the effects of structured postnatal education delivered by an educator to an individua...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Gagnon AJ,Bryanton J

    更新日期:2009-01-21 00:00:00

  • Steroidal contraceptives: effect on bone fractures in women.

    abstract:BACKGROUND:Steroidal contraceptive use has been associated with changes in bone mineral density in women. Whether such changes increase the risk of fractures later in life is not clear. However, osteoporosis is a major public health concern. Age-related decline in bone mass increases the risk of fracture, especially of...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Lopez LM,Grimes DA,Schulz KF,Curtis KM

    更新日期:2006-10-18 00:00:00

  • Rescue high frequency oscillatory ventilation vs conventional ventilation for infants with severe pulmonary dysfunction born at or near term.

    abstract:BACKGROUND:Pulmonary disease is a major cause of mortality and morbidity in term and near term infants. Conventional ventilation (CV) has been used for many years but may lead to lung injury, require the subsequent use of more invasive treatment such as extra corporeal membrane oxygenation (ECMO), or result in death. T...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Bhuta T,Clark RH,Henderson-Smart DJ

    更新日期:2001-01-01 00:00:00

  • Targeting intensive glycaemic control versus targeting conventional glycaemic control for type 2 diabetes mellitus.

    abstract:BACKGROUND:Patients with type 2 diabetes mellitus (T2D) have an increased risk of cardiovascular disease and mortality compared to the background population. Observational studies report an association between reduced blood glucose and reduced risk of both micro- and macrovascular complications in patients with T2D. Ou...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Hemmingsen B,Lund SS,Gluud C,Vaag A,Almdal TP,Hemmingsen C,Wetterslev J

    更新日期:2013-11-11 00:00:00

  • Eletriptan for acute migraine headaches in adults.

    abstract::This is the protocol for a review and there is no abstract. The objectives are as follows: The objective of the review will be to determine the efficacy and tolerability of eletriptan compared to placebo and other active interventions in the treatment of acute migraine headaches in adults. ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章


    authors: Derry S,Moore RA,McQuay HJ

    更新日期:2010-01-01 00:00:00

  • Topical antiseptics for chronic suppurative otitis media.

    abstract:BACKGROUND:Chronic suppurative otitis media (CSOM), sometimes referred to as chronic otitis media (COM), is a chronic inflammation and infection of the middle ear and mastoid cavity, characterised by ear discharge (otorrhoea) through a perforated tympanic membrane. The predominant symptoms of CSOM are ear discharge and...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析


    authors: Head K,Chong LY,Bhutta MF,Morris PS,Vijayasekaran S,Burton MJ,Schilder AG,Brennan-Jones CG

    更新日期:2020-01-06 00:00:00