Herz-Ruelas Maira Elizabeth, Álvarez-Villalobos Neri Alejandro, Millán-Alanís Juan Manuel, de León-Gutiérrez Humberto, Ocampo-Garza Sonia Sofía, Gómez-Flores Minerva, Grimalt Ramón
Servicio de Dermatología, Hospital Universitario "Dr. José Eleuterio González", U.A.N.L, Monterrey, Mexico.
Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic (KER Unit Mexico), Universidad Autónoma de Nuevo León, Monterrey, Mexico.
Skin Appendage Disord. 2020 Nov;6(6):338-345. doi: 10.1159/000510697. Epub 2020 Oct 9.
Androgenetic alopecia is the most common cause of hair loss [. 2011 Jan;164(1):5-15]. Finasteride and minoxidil are the only approved treatments [. 2008 Oct;59(4):547-8 and . 2018 Jan;32(1):11-22]. Dutasteride is more potent than finasteride due to its ability to inhibit both 5-α-reductase type I and II [. 2017 Sep;9(1):75-9] though its adverse effects and long half-life contribute to the reluctance on its oral use. Mesotherapy could be a feasible alternative to avoid systemic exposure and side effects [. 2009 Feb;20(1):137-45]. We aim to perform a systematic review to analyze scientific literature with the purpose of comparing efficacy and adverse effects of both administration routes. Five clinical trials using oral route and 3 intralesional in comparison with placebo met criteria for inclusion. Regarding intralesional dutasteride, only one study [. 2001 Mar;19(2):149-54] reported the mean change in hair count. Although both interventions favor over placebo, there are not enough data to reliably compare outcomes obtained between both routes. Mean increase in hair count observed with oral dutasteride was higher (MD: 15.92 hairs [95% CI: 9.87-21.96]; = <0.00001; = 90%) compared to intralesional dutasteride in Abdallah's study (MD: 7.90 hairs [95% CI: 7.14-8.66]; = <0.00001). Future studies are required to assess the therapeutic efficacy of both treatment routes, including head-to-head treatments before well-supported conclusions can be established.
雄激素性脱发是最常见的脱发原因[. 2011年1月；164(1):5 - 15]。非那雄胺和米诺地尔是仅有的获批治疗药物[. 2008年10月；59(4):547 - 8和. 2018年1月；32(1):11 - 22]。度他雄胺比非那雄胺更有效，因为它能够抑制I型和II型5-α还原酶[. 2017年9月；9(1):75 - 9]，不过其不良反应和长半衰期导致人们不愿口服使用它。中胚层疗法可能是一种可行的替代方法，以避免全身暴露和副作用[. 2009年2月；20(1):137 - 45]。我们旨在进行一项系统评价，分析科学文献，以比较两种给药途径的疗效和不良反应。五项使用口服途径和三项与安慰剂相比的皮损内注射的临床试验符合纳入标准。关于皮损内注射度他雄胺，只有一项研究[. 2001年3月；19(2):149 - 54]报告了毛发数量的平均变化。尽管两种干预措施都比安慰剂更有效，但没有足够的数据来可靠地比较两种途径获得的结果。在阿卜杜拉的研究中，口服度他雄胺观察到的毛发数量平均增加更高（MD: 15.92根毛发[95% CI: 9.87 - 21.96]； = <0.00001； = 90%），相比之下，皮损内注射度他雄胺的为（MD: 7.90根毛发[95% CI: 7.14 - 8.66]； = <0.00001）。需要进一步的研究来评估两种治疗途径的治疗效果，包括进行直接对比的治疗，才能得出有充分依据的结论。
