{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T11:20:20Z","timestamp":1783077620935,"version":"3.54.6"},"reference-count":49,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background: There is limited evidence on comparative effectiveness of off-label therapies approved by the United States Food and Drug Administration (FDA) for androgenetic alopecia (AGA) and the unregulated ones. Objective: To evaluate and compare the molecular mechanisms, clinical efficacy, and safety of off-label therapies for male AGA through a network meta-analysis (NMA). Methods: A systematic literature search in PubMed, Scopus, Web of Science, and ClinicalTrials.gov was conducted on 23 January 2026. We examined studies that assessed mean 6-month change in total hair density of off-label monotherapies, including topical minoxidil (2%, 5%) for male AGA. Sensitivity analyses were conducted. Results: Our search identified 23 studies (15 off-label and 8 topical minoxidil). We found topical minoxidil 5% to be ranked most effective. Other effective therapies included melatonin (topical), diaminopyrimidine oxide 1% (topical), procyanidin 1% (topical), saw palmetto (topical), exosome-based formulation containing plant-derived extracts (subcutaneous), cetirizine 1% (topical) and finasteride (topical). Conclusions: Our results substantiate topical minoxidil 5% being the most effective option; our findings also suggest that other off-label therapies demonstrate potential clinical benefit, warranting further high-quality comparative trials.<\/jats:p>","DOI":"10.3390\/medicina62071282","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T07:59:47Z","timestamp":1783065587000},"page":"1282","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond Minoxidil: Off-Label Therapies for Male Androgenetic Alopecia\u2014A Systematic Review with Network Meta-Analyses"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8664-7723","authenticated-orcid":false,"given":"Aditya K.","family":"Gupta","sequence":"first","affiliation":[{"name":"Division of Dermatology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada"},{"name":"Mediprobe Research Inc., London, ON N5X 2P1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon A. H.","family":"Compton","sequence":"additional","affiliation":[{"name":"Mediprobe Research Inc., London, ON N5X 2P1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5510-9608","authenticated-orcid":false,"given":"Amanda","family":"Liddy","sequence":"additional","affiliation":[{"name":"Mediprobe Research Inc., London, ON N5X 2P1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mesbah","family":"Talukder","sequence":"additional","affiliation":[{"name":"Mediprobe Research Inc., London, ON N5X 2P1, Canada"},{"name":"School of Pharmacy, BRAC University, Dhaka 1212, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9359-9750","authenticated-orcid":false,"given":"Tong","family":"Wang","sequence":"additional","affiliation":[{"name":"Mediprobe Research Inc., London, ON N5X 2P1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary A.","family":"Bamimore","sequence":"additional","affiliation":[{"name":"Mediprobe Research Inc., London, ON N5X 2P1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1038\/s41572-025-00656-9","article-title":"Androgenetic alopecia","volume":"11","author":"Liu","year":"2025","journal-title":"Nat. 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