Comparison of the Effectiveness 3% Tranexamic Acid Cream Versus 4% Hydroquinone Cream for Treatment of Epidermal Type Melasma

A B S T R A C TBackground: Melasma is an acquired hypermelanosis in areas that are exposed tosun. especially in face. Severity of melasma is measured using modified MelasmaArea Severity Index (mMASI) and Melanin Index (MI). Hydroquinone (HQ) is aneffective drug and also a gold standard in terms of melasma treatment. However. thedrawback of hydroquinone is the treatment duration which is quite long. theoccurence of side effects. and also recurrence potential. Several recent studies showsthat one of the anti-pigmentation agent options. the tranexamic acid (TA). is able toprevent melanocyte activation. The results of various studies found that the use ofTA showed a significant improvement in MASI scores. Objective: To compare theeffectivity of 3% TA cream with 4% HQ cream as an alternative therapy in epidermaltype melasma treatment. Methods: A double-blind. matched. randomized clinicaltrial was conducted during July 2019 until August 2019 at Dr. Mohammad HoesinGeneral Hospital Palembang. Subjects were divided into two groups. The first group.consists of 30 participants. get 3% TA cream; and the second group. consists of 30participants. get 4% HQ cream. Subjects who fulfilled the inclusion criteria wasincluded through a simple randomization. Study subjects wer given random creampot (with label A or B on it) according to the result of simple randomization. Finally.every subjects’ melasma severity was measured using mMASI and mexameter ® .Results: There were differences in terms of baseline. 4 th weeks and 8 th weeks aftertreatment mMASI scores in 3% TA and 4% HQ group. At 8 th week. the mMASI scorethe 3% TA group was lower than 4% HQ group. There was no differences in baseline.4 th weeks and 8 th after treatment MI between the two groups. Melanin index for 3%TA group was lower than 4% HQ group. Conclusion: Three-percent TA cream and4% HQ cream is effective in decreasing mMASI score and MI in epidermal typemelasma. There were differences in terms of the mMASI score during the 8th weekafter treatment between 3% TA and 4% HQ group.

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Comparison of the Effectiveness 3% Tranexamic Acid Cream Versus 4% Hydroquinone Cream for Treatment of Epidermal Type Melasma

BioScientia Medicina ◽

10.32539/bsm.v5i3.221 ◽

2021 ◽

Vol 5 (3) ◽

pp. 340-347

Author(s):

Hartika Ketty Marpaung ◽

Theresia L. Toruan ◽

Yuli Kurniawati ◽

Theodorus

Keyword(s):

Clinical Trial ◽

Side Effects ◽

Tranexamic Acid ◽

Gold Standard ◽

Treatment Duration ◽

Alternative Therapy ◽

Severity Index ◽

Inclusion Criteria ◽

Double Blind ◽

Melanin Index

Background: Melasma is an acquired hypermelanosis in areas that are exposed to sun. especially in face. Severity of melasma is measured using modified Melasma Area Severity Index (mMASI) and Melanin Index (MI). Hydroquinone (HQ) is an effective drug and also a gold standard in terms of melasma treatment. However. thedrawback of hydroquinone is the treatment duration which is quite long. the occurence of side effects. and also recurrence potential. Several recent studies shows that one of the anti-pigmentation agent options. the tranexamic acid (TA). is able to prevent melanocyte activation. The results of various studies found that the use of TA showed a significant improvement in MASI scores. Objective: To compare the effectivity of 3% TA cream with 4% HQ cream as an alternative therapy in epidermal type melasma treatment. Methods: A double-blind. matched. randomized clinical trial was conducted during July 2019 until August 2019 at Dr. Mohammad Hoesin General Hospital Palembang. Subjects were divided into two groups. The first group. consists of 30 participants. get 3% TA cream; and the second group. consists of 30 participants. get 4% HQ cream. Subjects who fulfilled the inclusion criteria was included through a simple randomization. Study subjects wer given random cream pot (with label A or B on it) according to the result of simple randomization. Finally. every subjects’ melasma severity was measured using mMASI and mexameter ® . Results: There were differences in terms of baseline. 4 th weeks and 8 th weeks after treatment mMASI scores in 3% TA and 4% HQ group. At 8 th week. the mMASI score the 3% TA group was lower than 4% HQ group. There was no differences in baseline. 4 th weeks and 8 th after treatment MI between the two groups. Melanin index for 3% TA group was lower than 4% HQ group. Conclusion: Three-percent TA cream and 4% HQ cream is effective in decreasing mMASI score and MI in epidermal type melasma. There were differences in terms of the mMASI score during the 8th week after treatment between 3% TA and 4% HQ group.

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Antiviral Treatment on Pregnancy with COVID-19 Infection : A Systematic Review

Indonesian Journal of Obstetrics & Gynecology Science ◽

10.24198/obgynia.v4n2s.329 ◽

2021 ◽

Vol 4 (2s) ◽

pp. 78-85

Author(s):

Tigor Peniel Simanjuntak ◽

◽

Angela Putri Kakerissa ◽

Grady Ivan Kurniawan

Keyword(s):

Systematic Review ◽

Side Effects ◽

Pregnant Women ◽

Gestational Age ◽

Treatment Duration ◽

Case Reports ◽

Antiviral Treatment ◽

Inclusion Criteria ◽

Duration Of Treatment ◽

Retrospective Case

Abstract Objective to evaluate antiviral treatment, duration, and side effects on pregnant women based on gestational age and severity of COVID-19 infection. Method: a systematic review of antiviral treatment, duration, and side effects on pregnant women based on gestational age and severity of COVID-19 infection. Systematic review was conducted following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) Statement. Result 948 papers accessed through Pubmed, Scopus, Science Direct, Cohcrane, and other with keywords “Antiviral”, “Pregnancy” “Pregnant” “Coronavirus” “COVID-19” “SARS-CoV-2”. Duplicate papers were excluded (n=302), topics and abstracts that do not meet the criteria (n=612), and 25 papers that did not meet the inclusion criteria. 9 papers that meet the inclusion criteria (case reports and cohort retrospective case study) discussed 20 pregnant women with COVID-19 infection (16 moderate and severe cases received Remdesivir, 3 moderate and mild cases received Lopinavir-ritonavir combination, and 1 moderate case received Arbidol). Conclusion, remdesivir is an antiviral frequently used in pregnancy on trimester II and III with severe COVID-19 infection with a duration of treatment of 5-10 days. Remdesivir should be monitored because some show side effects of increasing liver function. Key word: Antiviral, Pregnant, COVID-19

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A Double Blind Study of the Effect of Tranexamic Acid in Essential Menorrhagia

Thrombosis and Haemostasis ◽

10.1055/s-0038-1651301 ◽

1968 ◽

Vol 20 (03/04) ◽

pp. 583-587 ◽

Cited By ~ 21

Author(s):

J Vermylen ◽

M. L Verhaegen-Declercq ◽

M Verstraete ◽

F Fierens

Keyword(s):

Side Effects ◽

Oral Administration ◽

Tranexamic Acid ◽

Blind Study ◽

Double Blind Study ◽

Double Blind

SummaryOral administration of tranexamic acid, in a dosage of 3 g daily from the first day of menstruation onwards, significantly decreases menstrual haemoglobin loss in women with so-called essential menorrhagia.The frequency of side-effects reported did not differ between “active” and “placebo” periods.

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Tranexamic Acid in the Control of Spontaneous Bleeding in Severe Haemophilia

Thrombosis and Haemostasis ◽

10.1055/s-0038-1649074 ◽

1973 ◽

Vol 30 (02) ◽

pp. 272-279 ◽

Cited By ~ 11

Author(s):

S. G Rainsford ◽

A. J Jouhar ◽

Angela Hall

Keyword(s):

Side Effects ◽

Tranexamic Acid ◽

Transfusion Requirement ◽

Clinical Severity ◽

Severe Haemophilia ◽

Double Blind ◽

Spontaneous Bleeding ◽

Bleeding Episodes

SummaryA double-blind cross-over study of the prophylactic value of tranexamic acid (“Cyklokapron”), in a dose of 3.0 g per day, against spontaneous bleeding episodes in severe haemophilia was undertaken. Records of bleeding episodes were maintained during therapy in twenty boys with confirmed clinical severity, over two school terms. A significant reduction (p <0.05) in spontaneous bleeding episodes was attained with an associated lessening in the transfusion requirement of therapeutic material, and without obvious side effects. Recommendations are made for further investigations.

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Tranexamic Acid for Adults with Melasma: A Systematic Review and Meta-Analysis

BioMed Research International ◽

10.1155/2018/1683414 ◽

2018 ◽

Vol 2018 ◽

pp. 1-13 ◽

Cited By ~ 5

Author(s):

Lei Zhang ◽

Wei-Qiang Tan ◽

Qing-Qing Fang ◽

Wan-Yi Zhao ◽

Qi-Ming Zhao ◽

...

Keyword(s):

Systematic Review ◽

Tranexamic Acid ◽

Meta Analysis ◽

Skin Irritation ◽

Severity Index ◽

Treatment Side Effects ◽

Promising Therapeutic Approach ◽

Significant Difference ◽

Melanin Index ◽

Mean Differences

Objective. Melasma is a highly prevalent, chronic, and pigmentary disorder. This systematic review aims to evaluate the efficacy and safety of tranexamic acid (TA) for the treatment of adults with melasma. Methods. We independently searched 3 databases from beginning to 26 April, 2018. The study included 21 eligible trials. Two writers extracted data at the same time independently. Study outcomes were calculated by standardized mean differences (SMD) with 95% confidence intervals (CIs). All statistical analyses were performed using Review Manager Version 5.3 and STATA Version 15.1. Results. The combined results showed that the use of TA was associated with reduced Melasma Area and Severity Index (MASI) and Melanin Index (MI). No significant difference in Erythema Index (EI) was observed with TA treatment. Side effects were minor, with a few cases reporting mild gastrointestinal reaction, oligomenorrhoea, hypopigmentation, urticarial rash, and skin irritation xerosis. Conclusion. The meta-analysis suggested that TA treatment appeared to be a promising therapeutic approach for melasma.

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Efficacy of tranexamic acid on side effects of rhinoplasty: A randomized double-blind study

Journal of Cranio-Maxillofacial Surgery ◽

10.1016/j.jcms.2017.03.001 ◽

2017 ◽

Vol 45 (6) ◽

pp. 897-902 ◽

Cited By ~ 16

Author(s):

Mohammad Ali Ghavimi ◽

Koroush Taheri Talesh ◽

Arezoo Ghoreishizadeh ◽

Mir Amir Chavoshzadeh ◽

Ali Zarandi

Keyword(s):

Side Effects ◽

Tranexamic Acid ◽

Blind Study ◽

Double Blind Study ◽

Double Blind

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Evaluation of the efficacy of a topical chamomile-pumpkin oleogel for the treatment of plaque psoriasis: an intra-patient, double-blind, randomized clinical trial

Biomedical Research and Therapy ◽

10.15419/bmrat.v5i11.499 ◽

2018 ◽

Vol 5 (11) ◽

pp. 2811-2819

Author(s):

Sima Kolahdooz ◽

Mehrdad Karimi ◽

Nafiseh Esmaili ◽

Arman Zargaran ◽

Gholamreza Kordafshari ◽

...

Keyword(s):

Clinical Trial ◽

Placebo Group ◽

Side Effects ◽

Randomized Clinical Trial ◽

Plaque Psoriasis ◽

Severity Index ◽

Double Blind ◽

The Mean ◽

Psoriasis Severity

Background: Plaque psoriasis is a chronic inflammatory skin disease. Conventional treatments of psoriasis are not completely effective. In addition, unwanted side effects limit their long-term use. In this regard, developing new natural treatments with fewer side effects could be an alternative option. This study was designed to evaluate the efficacy and safety of topical chamomile-pumpkin oleogel (ChP) in treating plaque psoriasis. Methods: A total of 40 patients with mild-to-moderate plaque psoriasis were enrolled in this intra-patient, double-blind, block-randomized clinical trial. In each patient, bilateral symmetrical plaques were treated with ChP or placebo twice daily for four weeks. For clinical assessment, the Psoriasis Severity Index (PSI) and the Physician's Global Assessment (PGA) scale were evaluated at baseline and after the treatment. At the end of the study, patients' satisfaction with the treatment was evaluated using a visual analog scale (VAS) ranging from 0 to 10. For safety assessment, all treatment-related side effects were recorded. Results: Thirty-seven subjects (20 female, 17 male; age 20–60 years) completed the study. The mean decreases in the PSI score in the ChP group (4.09 +/- 2.24) were significantly (p = 0.000) greater than the placebo group (0.48 +/- 1.39). According to the PGA results, 13/37 (35%) of the ChP-treated plaques could achieve marked to complete improvement compared to 0% in the placebo group. Three patients dropped out from the study due to worsening of bilateral plaques during the first week of trial. Conclusion: Our results suggest that topically applied ChP could provide a safe and effective complementary option for psoriasis plaque management. IRCT registration code: IRCT2016092830030N1.

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Role of Oral Tranexamic Acid in Treating Patients of Melasma in A Charity Hospital of Lahore

10.53350/pjmhs211592490 ◽

2021 ◽

Vol 15 (9) ◽

pp. 2490-2492

Author(s):

Mariam Sheikh ◽

Ikram ur Rahim ◽

Muhammad Latif ◽

Rabail Majeed ◽

Muhammad Awais ◽

...

Keyword(s):

Side Effects ◽

Tranexamic Acid ◽

Severity Index ◽

Cross Sectional Study ◽

Monthly Basis ◽

Cross Sectional ◽

Treatment Side Effects ◽

Trust Hospital ◽

End Of Treatment ◽

Stopping Treatment

Objective: To evaluate the efficacy and safety of oral tranexamic acid (TA) in the treatment of melasma Method: This was a descriptive, cross sectional study which was performed in department of dermatology in Akhtar Saeed Trust Hospital, Lahore from April till December 2019. 70 patients of moderate to severe melasma were enrolled regardless of gender, > 18 years of age. 250 mg oral TA was given BD for 3 months along with broad spectrum topical sunscreen. Follow up done on monthly basis, 2 months after stopping the treatment. Photographs were taken at first visit & MASI (melasma area severity index) scoring done at start & after 3 months of treatment. Side effects were noted down if present. Results were recorded & analysed using SPSS. Results: A total of 70 patients were enrolled, 44 females and 26 males. Mean age of patients was 30.7. There was a significant decrease mean 3.4 in MASI scoring at 12 wks of treatment. 25 patients had good, 22 had fair, 7 had fair response to TA. No serious side effects were noted at end of treatment. No reversal of melasma was recorded at 2 months after stopping treatment. Conclusion: Oral tranexamic acid is a quick & effective treatment of patients of melasma. Key words: Melasma, tranexamic acid, treatment.

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Comparative Study of Combination of Oral Tranexamic Acid with Modified Kligman’s Formula Versus Oral Tranexamic Acid with Azelaic Acid 15% in the Treatment of Melasma

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i58a34132 ◽

2021 ◽

pp. 412-418

Author(s):

Riddhima Singh ◽

Praveen Maheshwari

Keyword(s):

Side Effects ◽

Tranexamic Acid ◽

Azelaic Acid ◽

Severity Index ◽

Fluocinolone Acetonide ◽

Once Daily ◽

Early Results ◽

Group A ◽

Group B

Background: Melasma refers to acquired hyper-pigmentary condition effecting skin. Owing to its multifactorial causation and chronicity, there is an increased need for new multimodality therapies to treat melasma more effectively and to prevent the side effects seen with the conventional modalities of treatment. Objectives: Compare efficacy of combining oral Tranexamic Acid and Azelaic Acid 15% with that of Oral Tranexamic Acid (TA) and Modified Kligman’s Formula. Also, to record any adverse effects of combining these agents. Methods: Patients having Melasma who will be coming to Dermatology OPD, AVBRH, Sawangi, Wardha, will be enrolled after considering the various inclusion and exclusion criteria. A detailed history will be asked, which will be followed by a cutaneous examination that includes the calculation of MASI (Melasma Area and Severity Index). One Group (A) - participants will receive - Oral 500 mg Tranexamic acid OD plus Modified Kligman’s Formula (fluocinolone acetonide 0.01%, tretinoin 0.05%, and hydroquinone 2%) cream one time at night only. Second Group (B)- participants will receive - Oral 500 mg Tranexamic Acid OD plus Azelaic Acid 15% gel once daily at night only. Both groups will also receive Broad-spectrum sunscreen SPF-30 daily (3 hourly). Patients will be called for regular follow up at 4 weeks and 8 weeks (for early results). Clinical photos will be clicked at every follow-up visit and MASI score shall be doocumented. Expected Results: To analyze efficacy of combining Oral TA along with Azelaic Acid 15% and if it provides better results, we can avoid the undesirable side effects that are seen on prescribing the Modified Klingman’s Formula, in Melasma patients. Conclusion: This study will help us in analyzing efficacy of combining Oral TA with Azelaic Acid 15%, therefore will provide a newer treatment modality with lesser side effects and maybe better results than the gold standard- Modified Klingman’s Formula.

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Evaluate the efficacy of intradermal tranexamic acid in melisma.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.03.4190 ◽

2021 ◽

Vol 28 (03) ◽

pp. 350-354

Author(s):

Tayyaba Iqbal ◽

Sadaf Ahmed Asim ◽

Madiha Sajid ◽

Sadia Hafeez ◽

Maria Mansoor ◽

...

Keyword(s):

Side Effects ◽

Tranexamic Acid ◽

Poor Response ◽

Severity Index ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Affected Area ◽

Strict Sun ◽

Study Setting

Objective: To evaluate the efficacy of intradermal tranexamic acid in melasma. Stduy Design: Cross-Sectional study. Setting: Out-patient Department of Dermatology at Dow University of Health Sciences. Period: January 2018 to June 2018. Material & Methods: Enrolling 73 patients the research was done on patients with resistant melasma. For this 0.2 ml tranexamic acid diluted in 0.8 ml normal saline was injected intradermally into the melasma lesion at 1 cm distance at every 2 weeks for 4 months and results were analysed by using the modified Melasma Area and Severity Index (MASI) at their first visit and then monthly with strict sun protection. A total of 73 patients were included in this study with age ranging from 22 years to 47 years. All of them had resistant melasma and had not taken any treatment for the last six months. Results: Out of 73 patient 10 (13.7%) patients had poor response, 48 (65.8%) patients had fair response, 14 (19.1%) patients had good responses and only 1 (1.4%) had excellent response. No significant side effects were observed. Out of 73 patients, 63 patients were satisfied with the treatment. Only 2 patients complained of redness over the affected area which subsided within a week without any intervention, no other side effects were noted. Conclusion: Intralesonal tranexamic acid is safe, effective and an affordable option in resistant melasma.

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