{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T20:54:51Z","timestamp":1788555291635,"version":"build-2803163510"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2024,6,8]],"date-time":"2024-06-08T00:00:00Z","timestamp":1717804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Melasma is a skin pigmentation disorder that lacks consistent treatment success, despite various methods used. Tranexamic acid (TXA) has shown hypopigmentation properties, but whether its administration should be combined with standard treatment has yet to be clarified. We aimed to perform an investigation of the effectiveness and safety of oral TXA as an adjuvant to triple combination cream (TCC) treatment in melasma. We searched PubMed, Embase and Cochrane (CENTRAL) for studies that compared TCC + adjuvant TXA to TCC treatment alone in patients with melasma. Outcomes of interest included change from the baseline Melasma Area and Severity Index (MASI) score, recurrence of melasma and adverse events. Statistical analysis was performed using R Studio 4.3.2. Four trials involving 490 patients were included. In the pooled analysis, the decrease from baseline in MASI score [mean difference \u20133.10, 95% confidence interval (CI) \u20135.85 to \u20130.35] was significantly higher in patients treated with oral TXA as an adjuvant to TCC compared with TCC alone. Melasma recurrence [risk ratio (RR) 0.28; 95% CI 0.16\u20130.49] was significantly lower in the group treated with TCC and TXA. Regarding erythema (RR 0.63, 95% CI 0.34\u20131.17) and burning (RR 0.59, 95% CI 0.30\u20131.17), no statistically significant difference was found. This meta-analysis demonstrated statistically significant benefits of TCC + TXA combination treatment compared with TCC alone. Furthermore, the results suggest that the addition of TXA to TCC treatment may reduce melasma recurrence.<\/jats:p>","DOI":"10.1093\/ced\/llae226","type":"journal-article","created":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T20:26:25Z","timestamp":1717791985000},"page":"1518-1524","source":"Crossref","is-referenced-by-count":2,"title":["Assessing the efficacy of oral tranexamic acid as an adjuvant to triple combination topical treatment in melasma: a meta-analysis of randomized controlled trials"],"prefix":"10.1093","volume":"49","author":[{"given":"Oc\u00edlio","family":"Ribeiro Gon\u00e7alves","sequence":"first","affiliation":[{"name":"Federal University of Piau\u00ed (UFPI) , Teresina ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Clara Foga\u00e7a","family":"de Souza","sequence":"additional","affiliation":[{"name":"University of Western S\u00e3o Paulo (Unoeste) , Presidente Prudente ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice Volpato","family":"Rocha","sequence":"additional","affiliation":[{"name":"Federal University of Paran\u00e1 (UFPR) , Curitiba ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel Silva","family":"Alves","sequence":"additional","affiliation":[{"name":"University of Western S\u00e3o Paulo (Unoeste) , Presidente Prudente ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Lu\u00eds Reis","family":"Freitas","sequence":"additional","affiliation":[{"name":"University of S\u00e3o Paulo (USP) , S\u00e3o Paulo ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamim Barbosa","family":"de Azevedo","sequence":"additional","affiliation":[{"name":"Federal University of Piau\u00ed (UFPI) , Teresina ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milene Vit\u00f3ria Sampaio","family":"Sobral","sequence":"additional","affiliation":[{"name":"University of Western S\u00e3o Paulo (Unoeste) , Presidente Prudente ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda Scrobot","family":"Handocha","sequence":"additional","affiliation":[{"name":"University Positivo , Curitiba ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline Baima","family":"de Melo","sequence":"additional","affiliation":[{"name":"Federal University of Piau\u00ed (UFPI) , Teresina ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,6,8]]},"reference":[{"key":"2024112216163368700_llae226-B1","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1590\/abd1806-4841.20143063","article-title":"Melasma: a clinical and 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