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Treatment Options for Hirsutism: A Systematic Review and Network Meta-Analysis

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dc.contributor.author Barrionuevo, Patricia
dc.contributor.author Nabhan, Mohammed
dc.contributor.author Altayar, Osama
dc.contributor.author Wang, Zhen
dc.contributor.author Erwin, Patricia J.
dc.contributor.author Asi, Noor
dc.contributor.author Martin, Kathryn A.
dc.contributor.author Murad, M. Hassan
dc.date.accessioned 2018-12-03T17:02:35Z
dc.date.available 2018-12-03T17:02:35Z
dc.date.issued 2018
dc.identifier.uri https://hdl.handle.net/20.500.12866/4268
dc.description.abstract Background: Several pharmacologic treatments for hirsutism are used in practice; however, their relative efficacy is unclear. Methods: We searched MEDLINE, EMBASE, and CENTRAL through January 2017 for randomized controlled trials (RCTs) with follow-up of at least 6 months that evaluated antiandrogens, insulin sensitizers, and oral contraceptives in women with hirsutism. Independent pairs of reviewers selected and appraised trials. Random-effects network meta-analysis was used to compare individual drugs and classes. Results: We included 43 trials. Estrogen-progestin oral contraceptives pills (OCPs), antiandrogens, and insulin sensitizers were superior to placebo, with standardized mean reductions (95% confidence intervals) of -0.94 (-1.49 to -0.38), -1.29 (-1.80 to -0.79), and -0.62 (-1.00 to -0.23), respectively. Antiandrogen monotherapy, the combination of OCP and antiandrogen, the combination of OCPs and insulin sensitizer, and the combination of antiandrogen and insulin sensitizer were superior to insulin sensitizer monotherapy. The combination of OCPs and antiandrogen was superior to OCPs. Antiandrogen monotherapy with flutamide, finasteride, and spironolactone were each superior to placebo but similar to each other in efficacy. OCPs containing levonorgestrel, cyproterone acetate, or drospirenone were similar in effectiveness to other OCPs or had trivial differences. The certainty in comparisons with placebo was moderate and for head-to-head comparisons was low. Conclusions: Estrogen-progestin OCPs, antiandrogens, and insulin sensitizers are superior to placebo for the treatment of hirsutism. en_US
dc.language.iso eng
dc.publisher Oxford University Press
dc.relation.ispartof urn:issn:1945-7197
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Drug Therapy, Combination en_US
dc.subject Androgen Antagonists en_US
dc.subject Contraceptives, Oral, Combined en_US
dc.subject Hirsutism en_US
dc.subject Hypoglycemic Agents en_US
dc.subject Insulin Resistance en_US
dc.subject Randomized Controlled Trials as Topic en_US
dc.title Treatment Options for Hirsutism: A Systematic Review and Network Meta-Analysis en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1210/jc.2017-02052
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE


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