Assessing the efficacy of oral tranexamic acid as an adjuvant to triple combination topical treatment in melasma: a meta-analysis of randomized controlled trials.

Autor:	Ribeiro Gonçalves O; Federal University of Piauí (UFPI), Teresina, Brazil., de Souza MCF; University of Western São Paulo (Unoeste), Presidente Prudente, Brazil., Rocha AV; Federal University of Paraná (UFPR), Curitiba, Brazil., Alves GS; University of Western São Paulo (Unoeste), Presidente Prudente, Brazil., Freitas JLR; University of São Paulo (USP), São Paulo, Brazil., de Azevedo BB; Federal University of Piauí (UFPI), Teresina, Brazil., Sobral MVS; University of Western São Paulo (Unoeste), Presidente Prudente, Brazil., Handocha AS; University Positivo, Curitiba, Brazil., de Melo CB; Federal University of Piauí (UFPI), Teresina, Brazil.
Jazyk:	angličtina
Zdroj:	Clinical and experimental dermatology [Clin Exp Dermatol] 2024 Nov 22; Vol. 49 (12), pp. 1518-1524.
DOI:	10.1093/ced/llae226
Abstrakt:	Melasma is a skin pigmentation disorder that lacks consistent treatment success, despite various methods used. Tranexamic acid (TXA) has shown hypopigmentation properties, but whether its administration should be combined with standard treatment has yet to be clarified. We aimed to perform an investigation of the effectiveness and safety of oral TXA as an adjuvant to triple combination cream (TCC) treatment in melasma. We searched PubMed, Embase and Cochrane (CENTRAL) for studies that compared TCC + adjuvant TXA to TCC treatment alone in patients with melasma. Outcomes of interest included change from the baseline Melasma Area and Severity Index (MASI) score, recurrence of melasma and adverse events. Statistical analysis was performed using R Studio 4.3.2. Four trials involving 490 patients were included. In the pooled analysis, the decrease from baseline in MASI score [mean difference -3.10, 95% confidence interval (CI) -5.85 to -0.35] was significantly higher in patients treated with oral TXA as an adjuvant to TCC compared with TCC alone. Melasma recurrence [risk ratio (RR) 0.28; 95% CI 0.16-0.49] was significantly lower in the group treated with TCC and TXA. Regarding erythema (RR 0.63, 95% CI 0.34-1.17) and burning (RR 0.59, 95% CI 0.30-1.17), no statistically significant difference was found. This meta-analysis demonstrated statistically significant benefits of TCC + TXA combination treatment compared with TCC alone. Furthermore, the results suggest that the addition of TXA to TCC treatment may reduce melasma recurrence. Competing Interests: Conflicts of interest The authors declare no conflicts of interest. (© The Author(s) 2024. Published by Oxford University Press on behalf of British Association of Dermatologists. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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