5％米诺地尔酊治疗雄激素性脱发疗效观察

雄激素性脱发(androgenetic alopecia,AGA)是临床上最为常见的脱发性疾病,表现为额部发际逐渐后退,或顶部头发逐渐稀疏、脱落,头发密度进行性减少[1].AGA常用的治疗方法有口服非那雄胺、外用米诺地尔、联合治疗、毛发移植等.米诺地尔是一种非特异性促进毛发生长的药物,是美国食品和药物管理局批准的惟一男女均可使用的治疗AGA的外用药.常用浓度有2％、3％和5％.     

螺内酯联合米诺地尔搽剂治疗女性雄激素源性脱发的疗效观察

目的:探讨螺内酯联合米诺地尔搽剂治疗女性雄激素源性脱发的临床疗效。方法:将84例女性雄激素源性脱发患者随机分成对照组(40例)和治疗组(44例)。对照组仅给予外用米诺地尔搽剂治疗;治疗组在外用米诺地尔搽剂治疗基础上给予口服螺内酯60 mg/d,连续服用6个月。治疗1、3、6个月后观察两组治疗效果及不良反应。结果:6个月后,治疗组有效率为59.09%,对照组有效率为37.50%,两组差异有统计学意义(2=3.91,P<0.05)。结论:螺内酯联合米诺地尔搽剂治疗女性雄激素源性脱发有效、安全,值得临床推广使用。     

外用米诺地尔治疗女性雄激素性脱发的系统评价

为评价米诺地尔治疗女性雄激素性脱发的安全性和有效性,检索中国生物医学文摘数据库、网络数据库PubMed、Ovid、Web of Science、UMI、elsevier以及Cochrane图书馆的临床对照试验资料库,搜集相关的随机对照试验,对其逐个进行质量评价,并进行Meta-分析。结果：纳入4个高质量的研究,共治疗606例患者。对治疗有效率的Meta-分析结果显示：米诺地尔与安慰剂比较（患者评价）,OR合并=1.98[95%CI（1.43～2.74）,P〈0.0001];米诺地尔与安慰剂比较（调查员评价）,OR合并=2.31[95%CI（1.65～3.24）,P〈0.00001]。脱发评估区域1cm^2非毳毛计数的Meta-分析表明：米诺地尔与安慰剂比较（第32周）,WMD合并=18.00[95%CI（5.10～30.90）,P=0.006];米诺地尔与安慰剂比较（32周和0周的均数变化）,WMD合并=14.88[95%CI（7.46～22.31）,P〈0.0001]。所有的研究均未发现严重的副作用。结论：外用2%米诺地尔治疗女性雄激素性脱发是安全、有效的。     

非那雄胺与米诺地尔治疗男性雄激素性秃发疗效比较

目的:比较1 mg非那雄胺、5%米诺地尔及两者联合治疗男性雄激素性秃发(AGA)的疗效.方法:观察206例Hamilton-Norwood分级为Ⅲv、Ⅳ和Ⅴ级的男性AGA患者,分别给予1 mg非那雄胺(68例)、5%米诺地尔(74例)、1 mg非那雄胺和5%米诺地尔联合治疗(64例),疗程6个月.结果:治疗3个月时,联合治疗组有效率优于非那雄胺组.6个月时非那雄胺组、米诺地尔组及联合治疗组有效率分别为67.65%、62.16%和81.25%,联合治疗组优于米诺地尔组.脱发程度和病程不同者有效率差异均具有统计学意义(P < 0.05).结论:非那雄胺和米诺地尔联合治疗男性AGA起效较早,病程较短、脱发程度较轻、疗程较长者治疗效果较好.     

5%米诺地尔酊联合670nm+830nm激光治疗雄激素性脱发的疗效评价

目的：评价670nm+830nm激光联合5%米诺地尔酊对雄激素性秃发的疗效。方法：将60例雄激素性秃发患者随机分为治疗组与对照组：对照组单纯外用5%米诺地尔酊治疗,治疗组在对照组基础上加用670nm+830nm激光照射治疗,每周治疗2次,30分钟/次,6个月后进行疗效评定。结果：实际完成治疗及观察人数58例（实验组2例失访),治疗组总有效率为85.7％,对照组为53.3％,差异显著（χ2=10.02 ,P<0.01）,两组不良反应发生率无显著差异(χ2=0 ,P>0.05）。结论：670nm+830nm激光联合5%米诺地尔酊治疗雄激素性秃发安全、有效,可推广应用。     

半夏泻心汤联合外用米诺地尔治疗胃热脾寒型雄激素性秃发的疗效观察

目的 观察半夏泻心汤联合外用米诺地尔对胃热脾寒型雄激素性秃发（AGA）的治疗效果。方法 选取我科2018年1月—2022年1月收治的AGA患者113例,按随机分为治疗组（56例）与对照组（57例）,对照组患者给予米诺地尔外用,治疗组在对照组基础上联合半夏泻心汤治疗。比较2组患者治疗后的临床疗效及中医伴随症状改善情况的差异和不良反应发生情况。结果 经过治疗,联合治疗组临床疗效更佳,中医伴随症状改善更为明显,与对照组比较差异有统计学意义。结论 半夏泻心汤联合外用米诺地尔治疗胃热脾寒型AGA疗效明确,值得临床借鉴。     

米诺地尔酊治疗脱发的临床观察

我科自2004年以来开始运用浙江万马药业有限公司生产的“5％米诺地尔酊”治疗男性型秃发和斑秃共143例，取得较满意效果。     

5%米诺地尔联合口服抗雄药物治疗雄激素性秃发早期脱发现象的初步探讨

目的：探讨5%米诺地尔联合口服抗雄药物治疗雄激素性秃发（AGA）早期的脱发现象,观察16周内头发脱落数量及特征。方法：收集AGA患者治疗期间（1～16周）脱发量数据,探究脱发量的变化特点。结果：67例AGA患者使用药物后,第2～8周脱发量相对第1周（基线）均明显增加（P<0.05）;且分别与第1周和第2周比较,第3周均呈现出脱发量明显增加的情况（P<0.05）,由此将脱发量变化百分比>68.22%（第3周脱发量变化百分比的均值）的情况定义为“脱发明显”。据此将患者分为脱发明显组39例（58.21%）和非脱发明显组28例（41.79%）。脱发明显组中,患者脱发量明显增加发生于第3～5周,随后第12周降至基线水平。脱发明显组中脱发量的时间变化、严重程度在男女中差异均无统计学意义（P>0.05）,仅20.51%患者每周脱发量变化百分比中的最大数值（简称为最大百分比）较第1周>3倍。结论：“脱发明显”多发生于AGA患者用药后第3～5周,约于第12周降至第1周水平,持续时间短且男女间无明显差别。“脱发明显”是药物作用的一种表现,也预示着毛囊可能由休止期转入生长期的正...     

蔓迪联合生发丸治疗雄激素源性脱发83例疗效观察

雄激素源性脱发病因复杂,受多因素影响。虽然治疗方法很多,但大多疗效不太满意。我们于2003年3月—2005年1月用5%米诺地尔(商品名:蔓迪)联合自制生发丸治疗本病,取得了很好的疗效,现将结果报告如下。1资料与方法1.1临床资料本组患者共83例,均为我院皮肤科门诊就诊者,根据典型的     

米诺地尔治疗脱发的药理与临床研究

米诺地尔可以通过多种途径促进毛发生长 ,外用米诺地尔系统吸收极少。已有充分的临床试验证实米诺地尔对雄激素性脱发、斑秃有较好的疗效 ,大规模的临床试验已证实外用米诺地尔治疗脱发是安全的。文中综述了米诺地尔治疗脱发的可能机制、临床研究和不良反应     

Clinical utility and validity of minoxidil response testing in androgenetic alopecia

Clinical response to 5% topical minoxidil for the treatment of androgenetic alopecia (AGA) is typically observed after 3–6 months. Approximately 40% of patients will regrow hair. Given the prolonged treatment time required to elicit a response, a diagnostic test for ruling out nonresponders would have significant clinical utility. Two studies have previously reported that sulfotransferase enzyme activity in plucked hair follicles predicts a patient's response to topical minoxidil therapy. The aim of this study was to assess the clinical utility and validity of minoxidil response testing. In this communication, the present authors conducted an analysis of completed and ongoing studies of minoxidil response testing. The analysis confirmed the clinical utility of a sulfotransferase enzyme test in successfully ruling out 95.9% of nonresponders to topical minoxidil for the treatment of AGA.     

Novel enzymatic assay predicts minoxidil response in the treatment of androgenetic alopecia

Topical minoxidil is the most common drug used for the treatment of androgenetic alopecia (AGA) in men and women. Although topical minoxidil exhibits a good safety profile, the efficacy in the overall population remains relatively low at 30–40%. To observe significant improvement in hair growth, minoxidil is typically used daily for a period of at least 3–4 months. Due to the significant time commitment and low response rate, a biomarker for predicting patient response prior to therapy would be advantageous. Minoxidil is converted in the scalp to its active form, minoxidil sulfate, by the sulfotransferase enzyme SULT1A1. We hypothesized that SULT1A1 enzyme activity in the hair follicle correlates with minoxidil response for the treatment of AGA. Our preliminary retrospective study of a SULT1A1 activity assay demonstrates 95% sensitivity and 73% specificity in predicting minoxidil treatment response for AGA. A larger prospective study is now under way to further validate this novel assay.     

Topical 5% minoxidil versus combined erbium YAG laser and topical 5% minoxidil in androgenetic alopecia: A randomized controlled trial

Background

Androgenetic alopecia (AGA) is the most common type of hair loss in men, and several treatment options have been proposed for it. Fractional ablative erbium YAG laser can promote hair growth through trans-epidermal drug delivery and the thermal stimulation of hair follicles; this study therefore aims to evaluate minoxidil alone and in combination with fractional ablative erbium YAG laser in male patients with AGA.

Methods

This study was performed on 30 male patients with moderate to severe AGA. Patients were equally randomized into two groups, and the intervention group was treated with 1 mL of topical 5% minoxidil twice daily and six sessions of 2940-nm ablative fractional erbium YAG laser, and the control group received topical 5% minoxidil alone. The assessment entailed photography, dermoscopy, and patient satisfaction based on a 7-point grading scale.

Results

Both groups showed statistically significant improvements in terms of patient satisfaction, photography, and dermoscopy scores. The group receiving a combination of laser and minoxidil treatment obtained a higher dermoscopy score than the patients receiving minoxidil alone (p-value = 0.016). Nonetheless, there was no difference between the two groups in terms of the photography score (p-value = 0.13).

Conclusion

Laser treatment can stimulate the hair follicles and also enhance the dermal delivery of minoxidil, which was found to be associated with slightly better outcomes in this study.     

Combined treatment with oral finasteride and topical minoxidil in male androgenetic alopecia: a randomized and comparative study in Chinese patients

Finasteride at 1 mg/day and 5% topical minoxidil are effective in male androgenetic alopecia (MAGA). However, studies describing their effects in Chinese individuals are scarce. 450 Chinese MAGA patients were randomly assigned to receive finasteride (n = 160), minoxidil (n = 130) and combined medication (n = 160) for 12 months. The patients returned to the clinic every 3 months for efficacy evaluation. And efficacy was evaluated in 428 men at treatment end, including 154, 122, and 152 in the finasteride, 5% minoxidil, and combination groups, respectively. All groups showed similar baseline characteristics, including age at enrollment, and duration and severity of alopecia (p > 0.05). At 12 months, 80.5, 59, and 94.1% men treated with finasteride, 5% minoxidil and the combination therapy showed improvement, respectively. Adverse reactions were rare (finasteride, 1.8%; minoxidil, 6.1%), and disappeared right after drug withdrawal. In conclusion, finasteride is superior to 5% minoxidil, while the combined medication showed the best efficacy.     

Sulfotransferase activity in plucked hair follicles predicts response to topical minoxidil in the treatment of female androgenetic alopecia

Two percent topical minoxidil is the only US Food and Drug Administration‐approved drug for the treatment of female androgenetic alopecia (AGA). Its success has been limited by the low percentage of responders. Meta‐analysis of several studies reporting the number of responders to 2% minoxidil monotherapy indicates moderate hair regrowth in only 13–20% of female patients. Five percent minoxidil solution, when used off‐label, may increase the percentage of responders to as much as 40%. As such, a biomarker for predicting treatment response would have significant clinical utility. In a previous study, Goren et al. reported an association between sulfotransferase activity in plucked hair follicles and minoxidil response in a mixed cohort of male and female patients. The aim of this study was to replicate these findings in a well‐defined cohort of female patients with AGA treated with 5% minoxidil daily for a period of 6 months. Consistent with the prior study, we found that sulfotransferase activity in plucked hair follicles predicts treatment response with 93% sensitivity and 83% specificity. Our study further supports the importance of minoxidil sulfation in eliciting a therapeutic response and provides further insight into novel targets for increasing minoxidil efficacy.     

Effects of minoxidil 2% vs. cyproterone acetate treatment on female androgenetic alopecia: a controlled, 12-month randomized trial

BACKGROUND: Hormone studies have demonstrated the androgen-dependent character of female androgenetic alopecia, but there have been few controlled studies of therapies for alopecia in women. OBJECTIVES: To compare topical minoxidil 2% and cyproterone acetate in the treatment of female alopecia. METHODS: Sixty-six women with female-pattern alopecia were randomly assigned for 12 cycles into two groups, 33 received two local applications (2 mL day-1) of topical minoxidil 2% plus combined oral contraceptive and 33 received cyproterone acetate 52 mg day-1 plus ethinyl oestradiol 35 microg for 20 of every 28 days. RESULTS: A mean reduction of 2.4 +/- 6.2 per 0.36 cm2 in hairs of diameter > 40 microm was observed in the cyproterone acetate group (P = 0.05) and a mean increase of 6.5 +/- 9 per 0.36 cm2 in the minoxidil group (P < 0.001). Comparison of the total number of hairs at 12 months and the body mass index (BMI) revealed a borderline positive correlation in the cyproterone acetate group (r = 0.39, P = 0.06) and a negative correlation in the minoxidil group (r = -0.42, P < 0.05). No significant difference was observed in the total number of hairs among cyproterone acetate patients according to the presence or absence of other symptoms of hyperandrogenism, whereas in the minoxidil group, the total number of new hairs was higher in patients with isolated alopecia (Delta = 8.1; P < 0.05). Variations in scalp seborrhoea were significant in both groups, but the result was better (for acne and hirsutism as well) in the cyproterone acetate group than in the minoxidil group (P < 0.001). CONCLUSIONS: Minoxidil treatment was more effective in the absence of other signs of hyperandrogenism, hyperseborrhoea, and menstrual cycle modifications when the BMI was low, and when nothing argued in favour of biochemical hyperandrogenism. Cyproterone acetate treatment was more effective when other signs were present and when the BMI was elevated, factors that favoured a diagnosis of biochemical hyperandrogenism.     

A novel topical combination of minoxidil and spironolactone for androgenetic alopecia: Clinical,histopathological, and physicochemical study

Topical minoxidil 5% are effective in androgenetic alopecia (AGA). Spironolactone acts as an androgen antagonist by competitively blocking androgen receptors. Studying the effect of topical minoxidil 5% gel and spironolactone gel 1% in management of AGA. The study includes 60 patients diagnosed as AGA; (group I): treated with topical minoxidil gel 5%, (group II): with topical spironolactone gel 1% and group (III) treated with combined minoxidil 5% and spironolactone 1% gel. All patients were followed up monthly throughout the treatment period. Scalp biopsy was taken before and after 12 months. In group I, the clinical response was in 90% of patients with variable degrees in improvement, in group II, the clinical response was in 80% of patients, meanwhile, in group III the clinical response was in all patients (100%). Histopathological examination of skin biopsy after treatment revealed significant increase in anagen hair on the other hand, both telogen and vellus hair was significantly decreased meanwhile, the T/V ratio was significantly increased. The results of this work revealed that topical minoxidil gel 5% and topical spironolactone gel 1% were effective in treatment of AGA, while the combination of two agents was better in treatment.     

Evaluation of platelet-rich plasma plus basic fibroblast growth factor combined with minoxidil in the treatment of androgenetic alopecia: A randomized controlled trial

Background

Platelet-rich plasma plus basic fibroblast growth factor (PRPF) has been confirmed to be a safe and valuable therapy for androgenetic alopecia (AGA). However, the efficacy of PRPF combined with minoxidil treatment remains unknown.

Objective

To assess the efficacy of combined PRPF and minoxidil treatment for AGA.

Methods

In this prospective, randomized controlled trial, 75 patients with AGA were randomly divided into three groups and were administered the following treatments: Group 1, direct intradermal PRPF injection; Group 2, topical minoxidil 5% twice daily; and Group 3, PRPF injection combined with minoxidil. The PRPF injection was performed three times, 1 month apart. Hair growth parameters were evaluated using a trichoscope until the sixth month of the study. Patient satisfaction and side effects were recorded during the follow-up.

Results

All patients showed improvements (p < 0.05) in hair count, terminal hair, and decrease in telogen hair ratio after treatment. The efficacy of PRPF complex therapy revealed significant improvements (p < 0.05) in hair count, terminal hair and growth rate, compared with monotherapy.

Limitations

Small sample size, short follow-up time and lack of quantification of GFs in PRPF.

Conclusion

The effect of complex therapy exceed both the effects of PRPF monotherapy and minoxidil treatment, which can be a beneficial AGA treatment strategy.