Six studies (1,805 patients) were included. The median quality assessment score was 8 (range 2 to 12). Follow-up periods ranged from three to 12 months.
In the network meta-analysis, there were no significant differences for resolution at three months for acyclovir plus prednisolone (OR 1.24, 95% CI, 0.79 to 1.94) and for valacyclovir plus prednisolone (OR 1.02, 95% CI, 0.73 to 1.42) when compared with prednisolone alone. Acyclovir (OR 0.44, 95% CI, 0.28 to 0.68) or valacyclovir (OR 0.60, 95% CI, 0.42 to 0.87) alone had significantly lower efficacy than prednisolone alone and neither was significantly different from placebo. Prednisolone-based treatment resulted in a two-fold increase in the chance of recovery at three months (OR 1.94, 95% CI, 1.55 to 2.42) compared with non-prednisolone-based treatment. The effects were generally similar at later follow-ups and when compared with the pairwise analyses (full results reported in the paper).