Yagiz Matthew Akiska, Paradi Mirmirani, Ingrid Roseborough, Erin Mathes, Tina Bhutani, Andrew Ambrosy, Crystal Aguh, Wilma Bergfeld, Valerie D Callender, Leslie Castelo-Soccio, George Cotsarelis, Brittany Gareth Craiglow, Nisha S Desai, Isabella Doche, Bruna Duque-Estrada, Dirk M Elston, Carolyn Goh, Lynne J Goldberg, Ramon Grimalt, Ali Jabbari, Victoria Jolliffe, Brett A King, Charlotte LaSenna, Yolanda Lenzy, Jenna C Lester, Nino Lortkipanidze, Kristen I Lo Sicco, Amy McMichael, Nekma Meah, Natasha Mesinkovska, Mariya Miteva, Arash Mostaghimi, Yuliya Ovcharenko, Melissa Piliang, Bianca Maria Piraccini, Adriana Rakowska, Kimberly S Salkey, Adriana Schmidt, Jerry Shapiro, Cathryn Sibbald, Rodney Sinclair, Poonkiat Suchonwanit, Susan Taylor, Antonella Tosti, Sergio Vañó-Galván, Dmitri Robert Wall, Jennifer M Fu
{"title":"脱发患者开始使用小剂量米诺地尔口服液：国际修正德尔菲共识声明。","authors":"Yagiz Matthew Akiska, Paradi Mirmirani, Ingrid Roseborough, Erin Mathes, Tina Bhutani, Andrew Ambrosy, Crystal Aguh, Wilma Bergfeld, Valerie D Callender, Leslie Castelo-Soccio, George Cotsarelis, Brittany Gareth Craiglow, Nisha S Desai, Isabella Doche, Bruna Duque-Estrada, Dirk M Elston, Carolyn Goh, Lynne J Goldberg, Ramon Grimalt, Ali Jabbari, Victoria Jolliffe, Brett A King, Charlotte LaSenna, Yolanda Lenzy, Jenna C Lester, Nino Lortkipanidze, Kristen I Lo Sicco, Amy McMichael, Nekma Meah, Natasha Mesinkovska, Mariya Miteva, Arash Mostaghimi, Yuliya Ovcharenko, Melissa Piliang, Bianca Maria Piraccini, Adriana Rakowska, Kimberly S Salkey, Adriana Schmidt, Jerry Shapiro, Cathryn Sibbald, Rodney Sinclair, Poonkiat Suchonwanit, Susan Taylor, Antonella Tosti, Sergio Vañó-Galván, Dmitri Robert Wall, Jennifer M Fu","doi":"10.1001/jamadermatol.2024.4593","DOIUrl":null,"url":null,"abstract":"<p><strong>Importance: </strong>The results of small studies suggest that off-label use of low-dose oral minoxidil (LDOM) may be safe and effective for patients with hair loss, but larger trials and standardized guidelines are lacking.</p><p><strong>Objective: </strong>To create an expert consensus statement for LDOM prescribing for patients with hair loss.</p><p><strong>Evidence review: </strong>The current literature on the pharmacological properties, adverse effect profile, and use of LDOM for patients with hair loss was reviewed. Topics of interest were identified, and a modified Delphi consensus process was created. A total of 43 hair loss specialist dermatologists from 12 countries participated in a modified Delphi process. Consensus was reached if at least 70% agreed or strongly agreed on a 5-point Likert scale.</p><p><strong>Findings: </strong>Over 4 survey rounds, 180 items in the first round, 121 items in the second round, 16 items in the third round, and 11 items in the fourth round were considered and revised. A total of 76 items achieved consensus including diagnoses for which LDOM may provide direct or supportive benefit, indications for LDOM compared to topical minoxidil, dosing for adults (18 years and older) and adolescents (aged 12 to 17 years), contraindications, precautions, baseline evaluation, monitoring, adjunctive therapy, and specialty consultation. Pediatric use and dosing items for children younger than 12 years, and LDOM titration protocols fell short of consensus.</p><p><strong>Conclusions and relevance: </strong>This international expert consensus statement regarding the off-label prescribing of LDOM for patients with hair loss can help guide clinical practice until more data emerge. Hair loss experts with experience treating pediatric patients were underrepresented on this expert panel. Future research should investigate best practices for LDOM use in pediatric patients. Other critical topics for further investigation include the comparative efficacy of topical minoxidil vs oral minoxidil, the safety of oral minoxidil for patients with a history of allergic contact dermatitis to topical minoxidil, the long-term safety of LDOM, and the use of other off-label forms of minoxidil, such as compounded formulations of oral minoxidil and sublingual minoxidil. As additional evidence-based data emerge, these recommendations should be updated.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5000,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Low-Dose Oral Minoxidil Initiation for Patients With Hair Loss: An International Modified Delphi Consensus Statement.\",\"authors\":\"Yagiz Matthew Akiska, Paradi Mirmirani, Ingrid Roseborough, Erin Mathes, Tina Bhutani, Andrew Ambrosy, Crystal Aguh, Wilma Bergfeld, Valerie D Callender, Leslie Castelo-Soccio, George Cotsarelis, Brittany Gareth Craiglow, Nisha S Desai, Isabella Doche, Bruna Duque-Estrada, Dirk M Elston, Carolyn Goh, Lynne J Goldberg, Ramon Grimalt, Ali Jabbari, Victoria Jolliffe, Brett A King, Charlotte LaSenna, Yolanda Lenzy, Jenna C Lester, Nino Lortkipanidze, Kristen I Lo Sicco, Amy McMichael, Nekma Meah, Natasha Mesinkovska, Mariya Miteva, Arash Mostaghimi, Yuliya Ovcharenko, Melissa Piliang, Bianca Maria Piraccini, Adriana Rakowska, Kimberly S Salkey, Adriana Schmidt, Jerry Shapiro, Cathryn Sibbald, Rodney Sinclair, Poonkiat Suchonwanit, Susan Taylor, Antonella Tosti, Sergio Vañó-Galván, Dmitri Robert Wall, Jennifer M Fu\",\"doi\":\"10.1001/jamadermatol.2024.4593\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Importance: </strong>The results of small studies suggest that off-label use of low-dose oral minoxidil (LDOM) may be safe and effective for patients with hair loss, but larger trials and standardized guidelines are lacking.</p><p><strong>Objective: </strong>To create an expert consensus statement for LDOM prescribing for patients with hair loss.</p><p><strong>Evidence review: </strong>The current literature on the pharmacological properties, adverse effect profile, and use of LDOM for patients with hair loss was reviewed. Topics of interest were identified, and a modified Delphi consensus process was created. A total of 43 hair loss specialist dermatologists from 12 countries participated in a modified Delphi process. Consensus was reached if at least 70% agreed or strongly agreed on a 5-point Likert scale.</p><p><strong>Findings: </strong>Over 4 survey rounds, 180 items in the first round, 121 items in the second round, 16 items in the third round, and 11 items in the fourth round were considered and revised. A total of 76 items achieved consensus including diagnoses for which LDOM may provide direct or supportive benefit, indications for LDOM compared to topical minoxidil, dosing for adults (18 years and older) and adolescents (aged 12 to 17 years), contraindications, precautions, baseline evaluation, monitoring, adjunctive therapy, and specialty consultation. Pediatric use and dosing items for children younger than 12 years, and LDOM titration protocols fell short of consensus.</p><p><strong>Conclusions and relevance: </strong>This international expert consensus statement regarding the off-label prescribing of LDOM for patients with hair loss can help guide clinical practice until more data emerge. Hair loss experts with experience treating pediatric patients were underrepresented on this expert panel. Future research should investigate best practices for LDOM use in pediatric patients. Other critical topics for further investigation include the comparative efficacy of topical minoxidil vs oral minoxidil, the safety of oral minoxidil for patients with a history of allergic contact dermatitis to topical minoxidil, the long-term safety of LDOM, and the use of other off-label forms of minoxidil, such as compounded formulations of oral minoxidil and sublingual minoxidil. 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Low-Dose Oral Minoxidil Initiation for Patients With Hair Loss: An International Modified Delphi Consensus Statement.
Importance: The results of small studies suggest that off-label use of low-dose oral minoxidil (LDOM) may be safe and effective for patients with hair loss, but larger trials and standardized guidelines are lacking.
Objective: To create an expert consensus statement for LDOM prescribing for patients with hair loss.
Evidence review: The current literature on the pharmacological properties, adverse effect profile, and use of LDOM for patients with hair loss was reviewed. Topics of interest were identified, and a modified Delphi consensus process was created. A total of 43 hair loss specialist dermatologists from 12 countries participated in a modified Delphi process. Consensus was reached if at least 70% agreed or strongly agreed on a 5-point Likert scale.
Findings: Over 4 survey rounds, 180 items in the first round, 121 items in the second round, 16 items in the third round, and 11 items in the fourth round were considered and revised. A total of 76 items achieved consensus including diagnoses for which LDOM may provide direct or supportive benefit, indications for LDOM compared to topical minoxidil, dosing for adults (18 years and older) and adolescents (aged 12 to 17 years), contraindications, precautions, baseline evaluation, monitoring, adjunctive therapy, and specialty consultation. Pediatric use and dosing items for children younger than 12 years, and LDOM titration protocols fell short of consensus.
Conclusions and relevance: This international expert consensus statement regarding the off-label prescribing of LDOM for patients with hair loss can help guide clinical practice until more data emerge. Hair loss experts with experience treating pediatric patients were underrepresented on this expert panel. Future research should investigate best practices for LDOM use in pediatric patients. Other critical topics for further investigation include the comparative efficacy of topical minoxidil vs oral minoxidil, the safety of oral minoxidil for patients with a history of allergic contact dermatitis to topical minoxidil, the long-term safety of LDOM, and the use of other off-label forms of minoxidil, such as compounded formulations of oral minoxidil and sublingual minoxidil. As additional evidence-based data emerge, these recommendations should be updated.
期刊介绍：
JAMA Dermatology is an international peer-reviewed journal that has been in continuous publication since 1882. It began publication by the American Medical Association in 1920 as Archives of Dermatology and Syphilology. The journal publishes material that helps in the development and testing of the effectiveness of diagnosis and treatment in medical and surgical dermatology, pediatric and geriatric dermatology, and oncologic and aesthetic dermatologic surgery.
JAMA Dermatology is a member of the JAMA Network, a consortium of peer-reviewed, general medical and specialty publications. It is published online weekly, every Wednesday, and in 12 print/online issues a year. The mission of the journal is to elevate the art and science of health and diseases of skin, hair, nails, and mucous membranes, and their treatment, with the aim of enabling dermatologists to deliver evidence-based, high-value medical and surgical dermatologic care.
The journal publishes a broad range of innovative studies and trials that shift research and clinical practice paradigms, expand the understanding of the burden of dermatologic diseases and key outcomes, improve the practice of dermatology, and ensure equitable care to all patients. It also features research and opinion examining ethical, moral, socioeconomic, educational, and political issues relevant to dermatologists, aiming to enable ongoing improvement to the workforce, scope of practice, and the training of future dermatologists.
JAMA Dermatology aims to be a leader in developing initiatives to improve diversity, equity, and inclusion within the specialty and within dermatology medical publishing.
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