Adjunction of oral tranexamic acid to topical hydroquinone for melasma: a systematic review
Abstract
BACKGROUND
Adjunction of oral tranexamic acid to standard topical agents such as topical hydroquinone is a new concept of melasma treatment. However, no systematic review compares the efficacy of the adjunction of oral tranexamic acid to topical hydroquinone with that of topical hydroquinone alone in melasma treatment.
METHODS
Three independently reviewers systematically searched through electronic databases including Cochrane Library, PubMed, Trip Database and Scopus and performed additional hand searching to identify all relevant trials that adjunction of oral tranexamic acid to topical hydroquinone in patients with melasma. We used Cochrane Collaboration Risk of Bias Tool for assessing risk of bias. We extracted the data from the included and later performed the meta-analysis.
RESULTS
Two RCTs were included in the systematic review with 360 patients with melasma; 180 in the adjunction of oral tranexamic acid to topical hydroquinone group and 180 in the topical hydroquinone alone group. One was conducted in Nepal, 2012 and another one was in Iran, 2016. MASI score reduction from baseline was similar between the two interventions at week 12 of their treatment (mean difference -2.32, 95% confidence interval -5.25 to 0.62; I2 =84%).
CONCLUSION
We found similar efficacy of using adjunction oral TA to topical HQ and that of using topical HQ alone in patients with melasma at week 12 of their treatment.
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