Starace Michela Valeria Rita, Gupta Aditya K, Bamimore Mary A, Talukder Mesbah, Quadrelli Federico, Piraccini Bianca Maria
Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
Skin Appendage Disord. 2024 Aug;10(4):293-300. doi: 10.1159/000538621. Epub 2024 Apr 29.
Oral finasteride and topical minoxidil are long-standing androgenetic alopecia (AGA) treatments; topical finasteride is a more recent medicine. Few studies have compared their therapeutic effects in postmenopausal women. We compared the therapeutic impact of topical finasteride (1-4 sprays of 0.25% topical finasteride solution daily for 12 months), oral finasteride (2.5 mg oral finasteride once daily for 12 months), and topical minoxidil (1 mL of topical minoxidil 5% twice daily for 12 months) in postmenopausal women with AGA.
We conducted Bayesian network meta-analyses of individual patient-level data insofar as four clinically relevant endpoints, namely, 12-month change in (1) total hair density, (2) hair diameter, (3) clinical photographs, and (4) patients' opinion of efficacy. Data were obtained through medical charts. Regimens' surface under the cumulative ranking distribution (SUCRA) values and relative effects - as per odds ratios - were computed.
As per SUCRA, the most and least effective regimens - across the four outcomes - were oral finasteride, and topical finasteride, respectively; however, no significant statistical differences were found (i.e., 0.05).
Oral finasteride is ranked more effective than the topical forms of minoxidil and finasteride; however, more studies are needed to confirm this result.
口服非那雄胺和外用米诺地尔是治疗雄激素性脱发（AGA）的常用药物；外用非那雄胺是一种较新的药物。很少有研究比较它们在绝经后女性中的治疗效果。我们比较了外用非那雄胺（每天1 - 4喷0.25%外用非那雄胺溶液，持续12个月）、口服非那雄胺（每天口服2.5 mg非那雄胺，持续12个月）和外用米诺地尔（每天两次外用1 mL 5%米诺地尔，持续12个月）对绝经后AGA女性的治疗效果。
我们对个体患者水平的数据进行了贝叶斯网络荟萃分析，涉及四个临床相关终点，即（1）总毛发密度、（2）毛发直径、（3）临床照片和（4）患者对疗效的评价在12个月内的变化。数据通过病历获得。计算了各治疗方案的累积排名分布下的面积（SUCRA）值和相对效应（以优势比表示）。
根据SUCRA，在这四个结果中，最有效和最无效的治疗方案分别是口服非那雄胺和外用非那雄胺；然而，未发现显著的统计学差异（即P>0.05）。
口服非那雄胺的疗效排名高于外用米诺地尔和外用非那雄胺；然而，需要更多的研究来证实这一结果。
