自体富血小板血浆能增加雄激素性脱发患者的毛发密度吗？随机临床试验的系统回顾和荟萃分析⋆。

IF 2.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia Pub Date : 2024-07-15 DOI:10.1016/j.abd.2024.01.002

Lucas Kieling , Ana Terezinha Konzen , Rafaela Koehler Zanella , Denis Souto Valente

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引用次数: 0

摘要

基本原理：富血小板血浆（PRP）在雄激素性脱发（AGA）中的应用越来越广泛：作者旨在评估 PRP 在 AGA 中与安慰剂相比的疗效：方法：作者对七个数据库进行了全面检索，检索期至 2023 年 4 月 1 日。方法：在 7 个数据库中进行了全面搜索，直至 2023 年 4 月 1 日。纳入了以 AGA 和使用 PRP 增加头发密度为重点的随机临床试验。纳入的患者年龄在 15 至 63 岁之间，根据诺伍德 I-VII 和路德维希 I-III 量表被诊断为 AGA。有样本量的研究结果：作者筛选了 555 份登记资料，纳入了 14 项研究（涉及 431 名患者）进行定性综合，并将 13 项研究纳入了荟萃分析。荟萃分析表明，平均差异为 27.55 根头发/平方厘米，95% CI (14.04; 41.06)，I2 = 95.99%，P 2 = 77.11% (P = 0.02)。即证据质量较低：研究的局限性：研究高度异质性，质量较低，存在明显的发表偏倚：结论：具有发表偏倚的高度异质性研究表明，PRP 可有效增加 AGA 患者的毛发密度，因此建议进一步开展高质量的随机临床试验以加强证据。

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Is autologous platelet-rich plasma capable of increasing hair density in patients with androgenic alopecia? A systematic review and meta-analysis of randomized clinical trials

Fundamentals

Platelet-rich plasma (PRP) has been progressively more used in androgenetic alopecia (AGA).

Objectives

The authors aimed to evaluate PRP efficacy compared to placebo in AGA.

Methods

A comprehensive search was conducted across seven databases, until 01/04/2023. Randomized clinical trials focusing on AGA and PRP use to increase hair density were included. Patients aged between 15 and 63 years, diagnosed with AGA characterized by Norwood I‒VII and Ludwig I‒III scales, were included. Studies with a sample size <10, lacking PRP processing method, focusing on complementary therapies or other alopecias, were excluded. The authors conducted subgroup analysis for activator, spin method, study design, risk of bias, and gender. Meta-regression was conducted for activator, spin method, design, and gender. The authors used GRADEpro to assess evidence certainty and the RoB-2 tool for risk of bias. Asymmetry was measured through a Funnel plot followed by Egger’s test. The protocol was registered at PROSPERO (CRD42023407334).

Results

The authors screened 555 registers and included fourteen studies involving 431 patients for qualitative synthesis, with 13 studies included in the meta-analysis. Meta-analysis demonstrated a mean difference of 27.55 hairs/cm² and 95% CI (14.04; 41.06), I² = 95.99%, p < 0.05. Hair diameter meta-analysis presented a mean difference of 2.02 μm, 95% CI (−0.85 μm; 4.88 μm), and I² = 77.11% (p = 0.02). That is, low quality evidence.

Study limitations

Studies were highly heterogeneous, of low quality, and presented evident publication bias.

Conclusions

Highly heterogeneous studies with publication bias suggest PRP effectively increases hair density in AGA, so further high-quality randomized clinical trials are recommended to strengthen the evidence.

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来源期刊

Anais brasileiros de dermatologia DERMATOLOGY-

CiteScore

2.40

自引率

0.00%

发文量

184

审稿时长

32 days

期刊介绍： The journal is published bimonthly and is devoted to the dissemination of original, unpublished technical-scientific study, resulting from research or reviews of dermatological topics and related matters. Exchanges with other publications may be accepted.