Oral tranexamic acid (TA) in the treatment of melasma: A retrospective analysis
Oral tranexamic acid (TA) in the treatment of melasma: A retrospective analysis
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DOI：
10.1016/j.jaad.2016.03.001
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发表时间：
2016-08-01
影响因子：
13.8
通讯作者：
Goh, Chee Leok
中科院分区：
文献类型：
--
作者：
Lee, Hwee Chyen;Thng, Tien Guan Steven;Goh, Chee Leok
背景：黄褐斑是亚洲人常见的色素性疾病，治疗具有挑战性。口服氨甲环酸（TA）已成为难治性黄褐斑的潜在治疗方法。关于其使用、结果和安全性的大规模研究有限。目的：我们试图评估口服TA治疗亚洲人群黄褐斑的治疗结果和不良反应。方法：我们对2010年1月至2014年6月在三级皮肤病中心接受口服TA治疗黄褐斑的患者进行了回顾性分析。结果：共入组561例患者（91.4%女性，8.6%男性）。中位治疗持续时间为4个月。大多数（503例[89.7%]）改善，56例（10.0%）无改善，2例（0.4%）恶化。无黄褐斑家族史患者的缓解率高于有家族史患者（90.6% vs 60.0%，P = 0.01）。在503名改善的患者中，在TA开始后2个月内观察到缓解，复发率为27.2%。40例（7.1%）发生不良事件。大多数为一过性，但1例发生深静脉血栓形成，需要立即停药。她后来被诊断为家族性蛋白S缺乏症。局限性：这是一项回顾性研究。结论：口服TA可能是一种有效的辅助难治性黄褐斑。在开始治疗前，应仔细筛查血栓栓塞的个人和家族危险因素。
Background: Melasma is a common pigmentary disorder among Asians and treatment is challenging. Oral tranexamic acid (TA) has emerged as a potential treatment for refractory melasma. Large-scale studies on its use, outcomes, and safety are limited.Objective: We sought to evaluate treatment outcomes and adverse effects of oral TA in melasma in an Asian population.Methods: We conducted a retrospective analysis of patients who received oral TA for melasma in a tertiary dermatologic center from January 2010 to June 2014.Results: In all, 561 patients (91.4% female, 8.6% male) were enrolled. Median duration of treatment was 4 months. The majority (503 [89.7%]) improved, 56 (10.0%) had no improvement, and 2 (0.4%) worsened. Patients without family history of melasma had better response rates than those with family history (90.6% vs 60.0%, P = .01). Of the 503 who improved, response was seen within 2 months of TA initiation, with a relapse rate of 27.2%. Adverse events occurred in 40 (7.1%). Most were transient, but 1 developed deep vein thrombosis requiring prompt discontinuation. She was later given the diagnosis of familial protein S deficiency.Limitations: This was a retrospective study.Conclusion: Oral TA may be an effective adjunct for refractory melasma. Careful screening for personal and familial risk factors for thromboembolism should be done before initiation.