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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.)

Introduction: Recent studies have demonstrated an association between hypoglycemic medications and neuroprotective action in neurodegenerative diseases, such as Parkinson's disease (PD). Therefore, in this meta-analysis, our objective was to evaluate the efficacy of these medications, compared to placebo, as disease-modifying therapy in patients with PD., Methods: We systematically searched PubMed, Embase, and Cochrane for studies comparing the use of hypoglycemic drugs and placebo in patients with PD. Statistical analyses were performed using R Studio 4.3.2. Mean difference (MD) with 95 % confidence intervals (CI) were pooled across trials. Outcomes of interest were change in Movement Disorders Society - Unified Parkinson's Disease Rating Scale (MDS-UPDRS) parts I, II, III, IV, and Parkinson's Disease Questionnaire 39 (PDQ-39)., Results: This meta-analysis included six randomized controlled trials (RCT) reporting data on 787 patients. Among them, 480 (61 %) received hypoglycemic drugs. Follow-up ranged from 36 to 61 weeks. At the end of follow-up, improvement in MDS-UPDRS part III score during OFF state occurred when subjects received any hypoglycemic agents at their lowest dose (MD -1.36; 95 % IC -2.78 to -0.47; I2 = 38 %), as well as highest doses (MD -1.58; 95 % IC -3.07 to -0.09; I2 = 50 %). Changes in MDS-UPDRS part III score in patients examined in the ON state who received any dose of any hypoglycemic agents (MD -3.32; 95 % IC -5.28 to -1.36; I2 = 0 %) were significant. There was no significant difference between groups MDS-UPDRS parts I, II, IV, and PDQ-39., Conclusion: In patients with PD, the use of hypoglycemic agents showed efficacy on symptomatic PD treatment with an improvement in MDS-UPDRS part III., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Competing Interests: The authors have no conflicts of interest to declare.

The benefits and potential risks of oral minoxidil therapy versus topical minoxidil therapy in patients with androgenetic alopecia (AGA) are controversial. We systematically searched PubMed, Embase, and Cochrane for randomized clinical trials (RCTs) comparing the use of oral minoxidil and minoxidil topical solution in patients with AGA. Statistical analyses were performed using R Studio 4.3.2. Standard mean difference (SMD) and risk ratio (RR) with 95% confidence intervals (CI) were pooled across trials. This meta-analysis included four RCTs reporting data on 279 patients. Follow-up ranged from 24 to 39 weeks. There were no differences in hair density (SMD 0.02; 95% CI -0.25 to 0.29; P = 0.88; I 2  = 0%) or hair diameter (SMD -0.25; 95% CI -0.75 to 0.26; P = 0.34; I 2  = 36%). The incidence of hypertrichosis was statistically significantly higher in the oral minoxidil group when compared to the topical minoxidil group (RR 2.01; 95% CI 1.18-3.41; P = 0.01; I 2  = 0%). There was no statistically significant difference between groups for the incidence of hypotension (RR 2.42; 95% CI 0.26-22.46; P = 0.44; I 2  = 0%). In patients with AGA, oral minoxidil and minoxidil topical solution have similar efficacy and safety, with equivalent improvements in hair density, hair diameter, and incidence of adverse events, such as hypotension., (© 2024 the International Society of Dermatology.)

Certain guidelines recommend a second-generation H1-antihistamine (AH) as first-line treatment for patients with chronic urticaria (CU). However, some patients show insufficient response to a standard dose of this therapy and might benefit from adding leukotriene receptor antagonists (LTA). Therefore, we aimed to perform a systematic review and meta-analysis comparing LTA plus antihistamines with antihistamines alone. We performed a systematic review and meta-analysis, searching PubMed, EMBASE, and Cochrane Central for randomized clinical trial (RCT) data comparing LTA plus AH treatment to AH alone in patients with CU. Statistical analysis was performed using R Studio 4.3.2. Heterogeneity was assessed with I 2 statistics. Three studies comprising 234 patients with urticaria were included. The mean age was 37.23 years in the leukotriene antagonist + antihistamines (LTA + AH) group and 39.14 years in the antihistamines (AH) group. Follow-up ranged from 2 to 18 months between studies. There was no statistically significant difference between groups in terms of TSS level (SMD: -74.82; 95% CI: -222.66 to 73.02; P = 0.32; I 2  = 98%), neither in terms of pruritus (MD: -0.07; 95% CI: -0.42 to 0.28; P = 0.70; I 2  = 74%). After sensitivity analysis, with the systematic exclusion of each study from the grouped estimates, the result for TSS level did not change. These findings suggest that leukotriene receptor antagonists with antihistamines do not have better outcomes than antihistamines alone regarding TSS and pruritus in patients with CU., (© 2024 the International Society of Dermatology.)