Efficacy and safety of compound glycyrrhizin in patients with alopecia areata: a systematic review and meta-analysis

Although compound glycyrrhizin (CG) has been widely used to alopecia areata (AA) in China, its efficacy and safety remain unclear. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of CG for AA. Eight literature databases were retrieved from their inceptions to 29 February 2024 to identify the eligible randomized controlled trials comparing CG plus conventional treatments with conventional treatments alone for the treatment of AA. Risk ratio (RR), mean difference and 95% confidence interval (CI) were used to estimate the pooled results. RevMan 5.4 (Cochrane Collaboration, Copenhagen, Denmark) and Stata 12.0 software (StataCorp., College Station, TX) were used for statistical analysis. A total of 23 eligible studies with 2219 patients were included. The pooled results revealed that CG plus conventional treatments was superior to conventional treatments alone in cure rate (RR = 1.60, 95%CI [1.47, 1.74], <i>p</i> &lt; .001), total efficacy rate (RR = 1.37, 95%CI [1.29, 1.45], <i>p</i> &lt; .001) and the Severity of Alopecia Tool (SALT) score, regardless of different conventional treatments, treatment courses and doses of CG. In terms of safety, a few patients suffered from adverse events (AEs), including oedema, elevated blood pressure and gastrointestinal tract discomfort, and the incidence of oedema was higher in the patients receiving CG (RR = 2.53, 95%CI [1.04, 6.19], <i>p</i> = .04). The combination of CG and conventional treatments was effective and safe for patients with AA, and CG could promote hair regrowth with mild AEs.