Factors influencing the effect of photobiomodulation in the treatment of androgenetic alopecia: A systematic review and analyses of summary-level data

Dissolving microneedles for alopecia treatment

Alopecia is a treatable benign disease, however, approximately 15-30% of women and 50% of men suffer from alopecia, which greatly affects patient's self-esteem and quality of life. Currently, commercial products for alopecia treatment include topical minoxidil solution, oral finasteride tablets and oral baricitinib tablets. However, the barrier of stratum corneum, systemic adverse effects and poor cure rate limit the application of commercial products. Therefore, researchers investigated the mechanism of alopecia, and developed new drugs that could target lactate dehydrogenase-related pathways, remove excessive reactive oxygen in hair follicles, and reduce the escape of hair follicle stem cells, thus injecting new strength into the treatment of alopecia. Moreover, starting from improving drug stratum corneum penetration and reducing side effects, researchers have developed hair loss treatment strategies based on dissolved microneedles (MNs), such as drug powders/microparticles, nanoparticles, biomimetic cell membranes, phototherapy and magnetically responsive soluble microneedles, which show exciting alopecia treatment effects. However, there are still some challenges in the practical application of the current alopecia treatment strategy with soluble microneedles, and further studies are needed to accelerate its clinical translation.

The use of photobiomodulation therapy for the management of chemotherapy-induced alopecia: a randomized, controlled trial (HAIRLASER trial)

PURPOSE

The purpose of this trial was to evaluate if photobiomodulation (PBM) can accelerate hair regrowth after chemotherapy in breast cancer patients and if this is correlated with a better quality of life (QoL).

METHODS

A randomized controlled trial with breast cancer patients that underwent an anthracycline and taxane-containing chemotherapy regimen was set up at the Jessa Hospital (Hasselt, Belgium). Patients were randomized into the control group (no intervention) or the PBM group (three PBM sessions each week for 12 weeks, starting the last day of their chemotherapy). Hair regrowth was evaluated based on photographic assessments. Two blinded researchers independently scored the hair regrowth using a numerical rating scale (NRS). In addition, the QoL was measured using the European Organization for Research and Treatment-QOL questionnaire and Breast Cancer-specific module (EORTC QLQ-C30 and QLQ-BR23). Data were collected on the day of their last chemotherapy session and 1, 2, and 3 months post-chemotherapy.

RESULTS

A total of 32 breast cancer patients were included in the trial between June 2020 and February 2022. Significantly higher NRS scores were observed in the PBM group at 1-month post-chemotherapy compared to baseline, whereas they remained constant in the control group. Patients allocated to the PBM group scored their global health significantly higher at all time points compared to the control.

CONCLUSION

Based on the results of the HAIRLASER trial, PBM seems to accelerate hair regrowth after chemotherapy in breast cancer patients resulting in an improved global health status and better body image. The study was registered in July 2019 at ClinicalTrials.gov (NCT04036994).

Clinically Significant Axial Shortening in Myopic Children After Repeated Low-Level Red Light Therapy: A Retrospective Multicenter Analysis

INTRODUCTION

Myopia is recognized as a progressive eye disease. The aim of this study was to evaluate the frequency and associated factors of clinically significant axial length (AL) shortening among myopic children following repeated low-level red light (RLRL) therapy.

METHODS

The clinical data that were collected for the myopic children aged 3-17 years who received an RLRL therapy delivered by home-use desktop light device that emitted light at 650 nm for at least 1 year, were reviewed. The clinical data included AL, spherical equivalent refraction (SER), and visual acuity measured at baseline and follow-up. The primary outcomes were frequency of AL shortening of > 0.05 mm, > 0.10 mm, and > 0.20 mm per year, and associated factors of AL shortening per year.

RESULTS

A total of 434 myopic children with at least 12 months of follow-up data were included. The mean age of participants was 9.7 (2.6) years with SER of -3.74 (2.60) diopters. There were 115 (26.50%), 76 (17.51%), and 20 (4.61%) children with AL shortening based on cutoffs of 0.05 mm/year, 0.10 mm/year, and 0.20 mm/year, respectively. In the multivariable model, AL shortening was significantly associated with older baseline age, female gender, and longer baseline AL or greater spherical equivalent refraction (all P < 0.05). Among AL shortened eyes, the mean AL difference (standard deviation, SD) was -0.142 (0.094) mm/year. Greater AL shortening was observed among children who were younger and had longer baseline AL (all P < 0.05).

CONCLUSIONS

More than a quarter of children had AL shortening > 0.05 mm following RLRL therapy, and the overall mean AL change was -0.142 mm/year. Further studies should explore the mechanisms underlying AL shortening.

Efficacy comparison of monotherapies and combination therapies for androgenetic alopecia: A Bayesian network meta-analysis

Even though a variety of treatments for androgenetic alopecia (AGA) currently have been using in clinical, satisfactory therapeutic methods are still lacking. We aimed to compare and rank these treatments for AGA according to their differences in efficacy via Bayesian network meta-analysis, suggesting the optimal therapy for clinical utility to refer. A systematic search of PubMed, Embase, Web of Science, and Cochrane Library database was performed and we included eligible randomized controlled trials. We compared differences in treatment effects of monotherapies and combination therapies using the Bayesian network model. The average difference in alteration from baseline of hair density and hair diameter, and variation value (mean ± SD) between the pre- and post-intervention was selected for main outcome measure and secondary outcome measure. Total 49 RCTs involving 3133 patients and six interventions were included. Regardless of based on hair density or hair diameter, topical/systemic combined with adjunctive therapeutics had the best treatment efficacy among all interventions (MD: 40.11; 95% CrI 25.65-54.59), followed by topical combined with systemic medical therapeutics (MD: 36.41; 95% CrI 17.54-55.24). In addition, in terms of hair density, treatment efficacy had significant difference sequentially among topical medical therapeutics (MD: 22.15; 95% CrI 12.88-31.42), systemic medical therapeutics (MD: 19.91; 95% CrI 6.504-33.22), and adjunctive therapeutics (MD: 18.60; 95% CrI 8.020-29.10) compared to placebo. In recent years, combination therapies are showing significant promise as potential therapies. Taken together with the outcomes of this study, despite the specific mechanism of the effect of combination therapies was not clear and further studies are needed, it may be the best treatment for AGA.