ABSTRACT

Laser-assisted drug delivery (LADD) is a new treatment for delivering drugs within the skin. This meta-analysis investigates the effectiveness and safety of the laser-assisted delivery of tranexamic acid (TXA) to treat melasma. A literature review was conducted by searching publication platforms to search for randomized controlled trials (RCTs) that compared laser-assisted delivery of TXA with laser-alone or topical TXA-alone treatment. The Embase, Web of Science, PubMed, Google Scholar, and Cochrane Library databases were searched, and Melasma Area Severity Index (MASI)/modified MASI (mMASI) scores used as the clinical improvement outcomes. All statistical analyses were performed using the RevMan software (Review Manager, V.5.3). The standardized mean differences and 95% confidence intervals were used to assess the results. Five RCTs were included in this meta-analysis. These studies used ablative fractional photothermolysis and nonablative dermal remodeling laser modalities. The results showed that both laser modalities combined with TXA significantly decreased the MASI/mMASI scores (P = .0003). Furthermore, no serious adverse events were observed, except mild erythema and burning pain. The meta-analysis found that the laser-assisted delivery of TXA is a new effective and safe treatment option for melasma treatment.

摘要

激光辅助药物递送 (LADD) 是一种在皮肤内递送药物的新疗法。本荟萃分析调查了激光辅助输送氨甲环酸 (TXA) 治疗黄褐斑的有效性和安全性。文献综述是通过搜索出版平台来搜索随机对照试验 (RCT) 进行的，这些试验将激光辅助递送 TXA 与单独使用激光或单独局部使用 TXA 进行比较。搜索了 Embase、Web of Science、PubMed、Google Scholar 和 Cochrane Library 数据库，并将黄褐斑面积严重程度指数 (MASI)/改良 MASI (mMASI) 评分用作临床改善结果。所有统计分析均使用 RevMan 软件（Review Manager，V.5.3）进行。标准化平均差和 95% 置信区间用于评估结果。该荟萃分析包括五项随机对照试验。这些研究使用烧蚀分数光热解和非烧蚀真皮重塑激光模式。结果表明，两种激光方式结合 TXA 显着降低了 MASI/mMASI 评分 (P = .0003)。此外，除了轻度红斑和灼痛外，没有观察到严重的不良事件。荟萃分析发现，激光辅助递送 TXA 是治疗黄褐斑的一种新的有效且安全的治疗选择。