Alopecia areata (AA) and treatment with simvastatin/ezetimibe: Experience of 20 patients

Loi, Camilla; Starace, Michela; Piraccini, Bianca Maria

doi:10.1016/j.jaad.2015.09.071

Cited by 30 publications

(24 citation statements)

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“…Despite the promising results of the initial pilot study [11], our findings regretfully are in line with Loi et al's [12] experience that simvastatin/ezetimibe is not effective for treatment of alopecia areata, at least in severe and/or cases refractory to other treatments, either as monotherapy or as adjuvant.…”

Section: Discussionsupporting

confidence: 78%

“…Subsequently, Loi et al [12] published their experience with simvastatin/ezetimibe treatment (Vytorin; Merck and Co.) 40/10 mg daily in 20 patients with severe alopecia areata. Inclusion criteria included interruption of any local or systemic treatments at least 20 days before enrollment.…”

Section: Discussionmentioning

confidence: 99%

“…Among treatments for alopecia areata evaluated in the past (isoprinosine [5], fumaric acid esters [6], and methotrexate [7,8]) and in the present (the JAK inhibitors tofactinib [9] and ruxolitinib [10]), oral simvastatin/ezetimibe therapy is currently under the scrutiny of expert opinion [11,12,13]. …”

Section: Introductionmentioning

confidence: 99%

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Unsuccessful Treatment of Alopecia Areata with Simvastatin/Ezetimibe: Experience in 12 Patients

Gouveia¹,

Trüeb²

2017

Skin Appendage Disord

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Background/Aims: Alopecia areata is a common immune-mediated hair condition with limited treatment options and success rates. There is evidence that statins, which are used for reducing atherogenesis and cardiovascular disease, have immunomodulatory activities and therefore may also be used for treatment of selected dermatologic conditions, including alopecia areata. Among treatments evaluated for alopecia areata, oral simvastatin/ezetimibe therapy is currently under the scrutiny of expert opinion. Methods: Prospective observational study of the efficacy and tolerability of simvastatin/ezetimibe 40/10 mg (Inegy; MSD Merck Sharp & Dohme AG, Lucerne, Switzerland) over a treatment period of 6 months in alopecia totalis, universalis, multipatch involvement of the scalp >30%, ophiasis, or diffuse alopecia areata. Results: Of the 12 patients included in the study, 67% had no hair regrowth, 24% transient diffuse or patchy hair regrowth, and 24% patchy regrowth of pigmented hair which was not considered cosmetically satisfactory. Adverse effects were observed in 24% of patients, who reported myalgia. One patient showed elevation of creatine phosphokinase. Conclusion: Simvastatin/ezetimibe is not effective for treatment of alopecia areata, at least in severe and/or cases refractory to other treatments, either as monotherapy or as adjuvant. Ultimately, in choosing such a treatment with questionable benefit, one must take the risk of serious adverse effects into careful consideration.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

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Unsuccessful Treatment of Alopecia Areata with Simvastatin/Ezetimibe: Experience in 12 Patients

Gouveia¹,

Trüeb²

2017

Skin Appendage Disord

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“…In AA, two small, uncontrolled pilot trials have investigated the use of simvastatin/ezetimibe to treat AA and have found conflicting results (Lattouf et al, 2015; Loi et al, 2016). Although it is not clear if the inconsistency could be due to differences in study design or limitations in power, it is intriguing to note that within the study that found a beneficial effect (Lattouf et al, 2015), the mean regrowth for women (71%) was greater than the mean regrowth for men (57%), supporting our identification of a gender effect in LDL levels among patients with AA (Figure 3).…”

Section: Big Data Insights Into Aa Comorbiditiesmentioning

confidence: 99%

Big Data Reveal Insights into Alopecia Areata Comorbidities

Lim

Severin

Petukhova

2018

Journal of Investigative Dermatology Symposium Proceedings

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Autoimmune diseases create a substantial burden of disease, and alopecia areata is among the more prevalent forms. Comorbidities are medical conditions that tend to occur together and may provide etiologic insights, suggest novel therapeutic strategies, and help patients and family members understand the risk of other health conditions. It is well established that having one autoimmune disease increases risk for others because of an underlying shared biology. Precision medicine initiatives are creating vast amounts of data that allow us to efficiently identify comorbidities. A survey across various datasets suggests that patients with autoimmune disease, and patients with alopecia areata in particular, may have comorbid neuropsychiatric and metabolic conditions.

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“…Case series were reported demonstrating the efficiency of daily dosage of simvastatin 40 mg and ezetimibe 10 mg in AA [55][56][57]. Contrarily, Loi et al reported a study of 20 patients (17 patients were evaluated) with recalcitrant AA, in which 14 of 17 were unresponsive [58]. All of these reports suggest that simvastatin/ezetimibe might be a promising agent in AA.…”

Section: Simvastatin/ezetimibementioning

confidence: 99%

New Modalities in the Treatment of Refractory Alopecia Areata

Kılıç¹

2017

Hair and Scalp Disorders

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Alopecia areata (AA) is a common and complex T-cell-mediated inflammatory disorder. It may be patchy (localized), involve the entire scalp (alopecia totalis) or entire body (alopecia universalis). Alopecia totalis and universalis are often difficult to treat. Although many therapeutic options currently exist in alopecia areata, none of them are curative or preventive. Besides, none of them are approved by Food and Drug Administration (FDA). The disease unfortunately has an unpredictable course. The factors indicating a poor prognosis are the extent of hair loss at the presentation, long duration of the disease, and ophiasis pattern of hair loss. There are only a few randomized controlled studies conducted on recalcitrant AA. Recent research on immunology of hair follicle and recent developments in immunopathogenesis, together with the shared pathways of the disease with other autoimmune disorders, led investigators to focus on novel therapies that target specific immunological pathways. Herein, we will review shortly the current treatment options in recalcitrant alopecia areata based on recently published studies and then will focus on the recently developed broad-spectrum and targeted therapeutics.

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Alopecia areata (AA) and treatment with simvastatin/ezetimibe: Experience of 20 patients

Cited by 30 publications

References 1 publication

Unsuccessful Treatment of Alopecia Areata with Simvastatin/Ezetimibe: Experience in 12 Patients

Unsuccessful Treatment of Alopecia Areata with Simvastatin/Ezetimibe: Experience in 12 Patients

Big Data Reveal Insights into Alopecia Areata Comorbidities

New Modalities in the Treatment of Refractory Alopecia Areata

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