PhD Scientific Days 2022

Clinical Medicine III.

Platelet-rich plasma in alopecia areata – a steroid-free treatment modality. A systematic review and meta-analysis of randomized clinical trials.

Text of the abstract

Introduction: Alopecia areata is a chronic autoimmune condition that can lead to a serious deterioration in the quality of life. The first line of treatment in patchy alopecia areata is triamcinolone acetonide; however, the efficacy of the treatment varies greatly.
Aims: Our aim was to investigate the therapeutic effects of platelet-rich plasma in the treatment of alopecia areata.
Method: We performed a systematic literature search in four databases: MEDLINE (via PubMed), Cochrane Library (CENTRAL), Embase, and Web of Science, from inception to 15 October 2021. The review protocol was registered on PROSPERO under registration number CRD42021282807. Our hypothesis was established during the study selection and tested after it. Our systematic review and meta-analysis are reported according to the PRISMA 2020 Statement. Randomized clinical trials (RCT) reporting on patients with AA treated with PRP were included, comparing PRP with TrA or placebo. Our systematic search provided a total of 2747 articles; we identified 4 studies eligible for qualitative analysis. The primary outcome was assessed with the use of the Severity of Alopecia Tool (SALT) score. Secondary outcomes were the Hair Regrowth Grade scale, Patient Global Assessment score, hair dystrophy, cytokine expression, burning/itching sensation, cell proliferation, and patient safety. A meta-analysis was performed regarding our primary outcome.
Results: Pooled mean differences from 4 RCTs with a total of 201 subjects did not show a significant difference in the mean change in Severity of Alopecia Tool score when platelet-rich plasma and triamcinolone acetonide groups were compared (MD = - 2.04, CI: -4.72-0.65; I2 = 80.4%, p = 0.14).
Conclusion: Platelet-rich plasma is a promising topical steroid-free treatment modality in the therapy of alopecia areata. No significant difference was found between platelet-rich plasma and triamcinolone acetonide treatment; however, further high-quality randomized clinical trials are needed to further assess the efficacy of platelet-rich plasma treatment and strengthen the quality of evidence.
Funding: Funding was provided by the Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.