The “NOMINAL” trial: Clinical efficacy, cosmetic acceptability, and local tolerability of topical 5% minoxidil lotion without propylene glycol: A 6-month, multicentre, real-life, prospective, assessor-blinded study in 196 subjects with hair loss.

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Published Jun 16, 2021
DOI: https://doi.org/10.18103/mra.v9i6.2515

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Main Article Content

Laura Alessi, MD
Dermatology out-patient Service Catania
Maria Catena Aloisi, MD
Dermatology out-patient Service Messina
Valentina Amadu, MD
Dermatology out-patient Service Sassari
Alex Arena, MD
Dermatology out-patient Service Reggio Calabria
Ylenia Balice, MD
Dermatology out-patient Service Lissone
Stefania Bano, MD
Dermatology out-patient Service Padua
Stefania Barruscotti, MD
Dermatology out-Patient service Pavia
Annunziata Bartolotta, MD
Dermatology out-patient Service, Vibo Valentia
Silvia Bondino
Dermatology out-patient Service Udine
Arianna Corsini, MD
Dermatology out-patient Service Livorno
Donato Di Nunno, MD
Dermatology out-patient Service Rome
Stefania Farina, MD
Dermatology out-patient Service Trento
Paola Nappa, MD
Dermatology out-patient Service Naples
Luigi Pisano, MD
Dermatology out-patient service Florence
Fabrizio Presta, MD
Dermatology out-patient Service Verona
Nicolò Rivetti, MD
Dermatology out-patient service Vigevano
Elena Saccani, MD
Dermatology out-patient Service Bologna
Marco Tomassini, MD
Dermatology out-patient Service Perugia
Sonia Torti, MD
Dermatology out-patient Service Pavia
Fabrizio Vaira, MD
Dermatology out-patient service Milano, Italy
Giovanni Zanframundo, MD
Dermatology out-patient Service Bari
Mario Puviani, MD
Medica Plus Dermatology Service Modena, Italy
Klause Eisendle, MD
Dermatology Clinic, Ospedale Centrale di Bolzano (BZ), Italy
Massimo Milani, MD
Medical Department Cantabria Labs Difa Cooper

Abstract

Background and Trial Objectives:


A new propylene glycol (PG)-free 5% minoxidil (Mnx) (PG-Free-Mnx) lotion has been recently commercialized. Clinical efficacy and local tolerability have been, so far, documented in a limited number of patients. The aim of this study was to evaluate the clinical efficacy, cosmetic acceptability, and local tolerability of 6-month application of this new PG-Free Mnx lotion in a real-life situation.


Materials and Methods:


The NOMINAL (NO-PG MINoxidil reAL life study) trial was performed in 22 out-patients Italian dermatology clinics. A total of 196 subjects of both sexes with a diagnosis of androgenic alopecia (AGA) and female androgenic alopecia (FAGA) were enrolled in the trial, after their written informed consent. PG-Free-Mnx lotion was applied 1 ml twice daily for 6 months. Clinical efficacy was evaluated in an open fashion in all the enrolled subjects with a 5-grade scale score (from-2: severe worsening, to +2: very good improvement in comparison with baseline condition). In a subgroup of subjects (n=60) an assessor-blinded clinical efficacy evaluation has been also performed using high definition standardized and coded scalp global pictures at baseline, and after 6 months by an assessor unaware of the temporal sequence using a 3-grade score (from 0: no improvement to 3: very high improvement). Cosmetic acceptability evaluation was assessed using a 7-item questionnaire using a 10-point scale score, with score 1 meaning not at all and score 10 meaning the worst possible condition. Cosmetic acceptability and clinical efficacy were evaluated after 12 and 24 weeks of treatment. Global tolerability, assessed at week 24, was evaluated with a 4-grade scale score (from -1: very low tolerability to +2: very good tolerability).


Results:


All but seven (3.6%) subjects concluded the study. Clinical efficacy scores (open evaluation) were 0.8±0.7 and 1.0±0.7 at week 12 and 24, respectively. Good or very good clinical response (score +1 or +2) at week 12 and week 24 was observed in 64% and 74% respectively of the subjects with a similar response in women (75%) and men (73%). Baseline severity of AGA/FAGA was inversely correlated with the clinical response with a better outcome in subjects with AGA type II in comparison with subjects with types III/IV AGA. The clinical efficacy was confirmed by the assessor-blinded evaluation of the subgroup of 60 subjects’ pictures at baseline (clinical score at baseline:  0.2±0.4 vs. 1.8±0.7 after 6 months; p=0.0001; absolute mean difference: 1.6; 95% CI: 1.1 to 2.0).  Cosmetic acceptability score mean values were always <2 at each time-point evaluation, demonstrating good or very good acceptability. Global Tolerability score mean±SD value was 1.7±0.4 with 94% of the subjects reporting good or very good tolerability with no differences between men and women. No subjects reported severe or very severe (Tolerability score >7) burning, itching or redness sensations.


Conclusions:


This new PG-free lotion shows, in real-life conditions, a very good cosmetic acceptability and tolerability profile. Clinical efficacy, evaluated both in open and assessor-blinded fashions, was also documented, and it was in line with the available data of traditional Mnx formulations with propylene glycol.

Keywords: Androgenetic alopecia, Minoxidil, propylene glycol, real-life trial

Article Details

How to Cite
ALESSI, Laura et al. The “NOMINAL” trial: Clinical efficacy, cosmetic acceptability, and local tolerability of topical 5% minoxidil lotion without propylene glycol: A 6-month, multicentre, real-life, prospective, assessor-blinded study in 196 subjects with hair loss.. Medical Research Archives, [S.l.], v. 9, n. 6, june 2021. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/2515>. Date accessed: 21 nov. 2024. doi: https://doi.org/10.18103/mra.v9i6.2515.
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Issue
Vol 9 No 6 (2021): Vol.9 Issue 6, June,2021
Section
Research Articles

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