Interventions for Morphea

The document reviewed 14 trials involving 429 participants to assess the effects of treatments for morphea, an immune-mediated disease characterized by excess collagen in the skin. The trials included various therapies such as topical, intralesional, and systemic medications. One trial with 70 juvenile participants suggested that oral methotrexate combined with oral prednisone may improve disease activity or damage in juvenile active morphea compared to placebo plus oral prednisone, but with a slightly increased risk of adverse events. Another trial compared medium-dose UVA-1, low-dose UVA-1, and narrowband UVB phototherapy in children and adults with active morphea, finding little or no difference in global improvement of disease activity or damage between the treatments. UVA-1 phototherapy may cause more mild tanning than narrowband UVB. However, these results are based on low-quality evidence due to high risk of bias and imprecision, and the authors recommend multicentre randomized controlled trials to better evaluate treatment responses.