Italian National Blood Centre, National Institute of Health, Rome, Italy.
Blood Transfus. 2023 Jan;21(1):24-36. doi: 10.2450/2021.0216-21. Epub 2021 Nov 15.
The number of articles evaluating the efficacy of platelet-rich plasma (PRP) in androgenetic alopecia (AGA) and alopecia areata (AA) has increased exponentially during the last years. This systematic review and meta-analysis is aimed at evaluating the benefit of PRP in the treatment of alopecia.
We searched MEDLINE (through PUBMED), Embase, and CENTRAL for relevant data. Treatment effect was described by mean difference (MD) and risk difference with 95% confidence intervals (CI). The GRADE system was used to assess the certainty of the body of evidence.
We found 27 controlled trials (1,117 subjects) that met our inclusion criteria: 18 trials (713 subjects) in patients with AGA, and 9 (404 subjects) in patients with AA. Eleven studies had a split head design. There was heterogeneity in types of PRP (e.g., activated and non-activated) and administration schedules. PRP was compared to saline injections (18 studies), local steroid injections (4 studies) and other comparators (5 studies). Most commonly reported outcomes were hair density and hair regrowth. It was not possible to pool all outcome data because of heterogeneity in reporting, and because reporting was often limited to a single study. Compared to saline injections, PRP injections increased hair density over a medium-term follow-up (MD, 25.6 hairs/cm; 95 % CI: 2.62-48.57), but the evidence was rated as low quality due to inconsistency and risk of bias. In individuals with AA, it is unclear whether PRP injection compared with triamcinolone injection increase the rate of subjects with hair regrowth (very-low quality of evidence due to inconsistency, imprecision, and risk of bias). There were no serious adverse events related to PRP injection or control treatments.
There is limited evidence showing benefit of PRP for treatment of alopecia, and most of this evidence is of low quality.
近年来，评估富血小板血浆（PRP）治疗雄激素性脱发（AGA）和斑秃（AA）疗效的文章数量呈指数级增长。本系统评价和荟萃分析旨在评估 PRP 在脱发治疗中的益处。
我们在 MEDLINE（通过 PUBMED）、Embase 和 CENTRAL 中搜索相关数据。治疗效果用均数差（MD）和 95%置信区间（CI）表示风险差异。使用 GRADE 系统评估证据体的确定性。
我们发现 27 项符合纳入标准的对照试验（1117 例患者）：18 项（713 例患者）AGA 患者，9 项（404 例患者）AA 患者。11 项研究采用了头部分区设计。PRP 的类型（如激活和非激活）和给药方案存在异质性。PRP 与生理盐水注射（18 项研究）、局部皮质类固醇注射（4 项研究）和其他对照（5 项研究）进行比较。最常报告的结局是头发密度和头发生长。由于报告的异质性以及报告通常仅限于单个研究，因此无法对所有结局数据进行汇总。与生理盐水注射相比，PRP 注射可在中期随访时增加头发密度（MD，25.6 根/cm；95%CI：2.62-48.57），但由于不一致性和偏倚风险，证据质量被评为低质量。在 AA 患者中，PRP 注射与曲安奈德注射相比是否增加头发生长的患者比例尚不清楚（由于不一致性、不精确性和偏倚风险，证据质量为极低）。PRP 注射或对照治疗无严重不良事件相关。
有有限的证据表明 PRP 治疗脱发有效，但大部分证据质量较低。
