Comparative efficacy of medical treatments for Vernal kerato
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A Study was conducted to systematically review the literature on the treatment of vernal keratoconjunctivitis (VKC) in children and young adults and conduct the comparative efficacy analysis on clinical signs and symptoms using network meta?analysis.

Patients with VKC under the age of 20 were randomized into one of two groups: intervention (any medical intervention) or comparator (active treatment, placebo treatment, or no treatment control), with predetermined symptoms (itching, tearing, photophobia, and foreign body sensation) and signs (hyperaemia, punctate keratitis, HornerTrantas dots, and macropapillae) recorded. The Cochrane probability of bias tool was used to assess the risk of bias in studies. Network metaanalyses were used to make distinctions.

--39 studies with data on 2046 individuals were identified. 23 studies were eligible for quantitative analysis. None were on systemic therapy.

--Temporal trend analysis showed that an initial focus on topical mast cell stabilizers turned to a focus on calcineurin inhibitors and a more diverse variety of pharmacological strategies. Studies varied in population, treatment duration and quality.

--The quantitative analysis revealed that efficacy of different therapies differed substantially across important clinical signs and symptoms, but there was a general trend of superior efficacy when using topical corticosteroids with stronger efficacy of the more potent corticosteroids.

Finally, the researchers offer a summary of RCTs that compare the effectiveness of treatments for VKC in children and young adults, which varies depending on symptoms and signs. Overall, topical corticosteroids were found to be more effective than oral corticosteroids.