Apremilast in refractory alopecia areata

Estébanez, Andrea; Estébanez, Nuria; Martín, J.M.; Montesinos, E.

doi:10.4103/ijt.ijt_59_19

Cited by 13 publications

(9 citation statements)

References 9 publications

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“…[152][153][154]. In vivo results in human are contradictory with a lack of efficacy of apremilast in some recent studies of severe AA but also some case reports with positive effects [151,[155][156][157].…”

Section: Pde4 Inhibitormentioning

confidence: 99%

Alopecia areata: a review on diagnosis, immunological etiopathogenesis and treatment options

Sterkens

Lambert

2021

Clin Exp Med

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Patients suffering from alopecia areata (AA) can lose hair in focal regions, the complete scalp, including eyelashes and eyebrows, or even the entire body. The exact pathology is not yet known, but the most described theory is a collapse of the immune privilege system, which can be found in some specific regions of the body. Different treatment options, local and systemic, are available, but none of them have been proven to be effective in the long term as well for every treatment there should be considered for the possible side effects. In many cases, treated or non-treated, relapse often occurs. The prognosis is uncertain and is negatively influenced by the subtypes alopecia totalis and alopecia universalis and characteristics such as associated nail lesions, hair loss for more than 10 years and a positive familial history. The unpredictable course of the disease also makes it a mental struggle and AA patients are more often associated with depression and anxiety compared to the healthy population. Research into immunology and genetics, more particularly in the field of dendritic cells (DC), is recommended for AA as there is evidence of the possible role of DC in the treatment of other autoimmune diseases such as multiple Sclerosis and cancer. Promising therapies for the future treatment of AA are JAK-STAT inhibitors and PRP.

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Section: Pde4 Inhibitormentioning

confidence: 99%

Alopecia areata: a review on diagnosis, immunological etiopathogenesis and treatment options

Sterkens

Lambert

2021

Clin Exp Med

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“…1,2 It is manifested by erythematous and itchy papules located often in areas covered by bathing suits during or immediately after exposure to sea water. [1][2][3][4][5][6][7] We report two cases of SBE mimicking Koebner Phenomenon (KP) as envenomations caused by the hydromedusa Olindias sambaquiensis and the scyphomedusa Chrysaora lactea, some of the most common jellyfish species in S and SE Brazil. Victims were a 7-year-old child and a 19-year-old man who had pruritus and erythematous papules that appeared during sea baths in Santa Catarina state, southern Brazil.…”

Section: Emergency Doctor's Ability To Diagnose Hidradenitis Suppurativamentioning

confidence: 99%

Emergency Doctor's ability to diagnose Hidradenitis Suppurativa

Bouazzi

Riis

Jemec

2020

Acad Dermatol Venereol

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In their study, Choi et al. 5 noted that cilostazol, a PDE3 inhibitor, could experimentally promote hair growth by stimulating human dermal papilla cell (hDPC) proliferation, enhancing hair shaft elongation and prolongation of anagen induction in C57BL/6 mice. Later, Choi et al. 6 measured the expression of PDE5A and found that PDE5A mRNA and protein were highly expressed in hDPCs and human hair follicles (hHFs). Sildenafil also increased the mRNA expression of vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF) in hDPCs, which stimulate secretion of these factors, and can promote proliferation of hDPCs. Further, sildenafil may affect perifollicular angiogenesis around hair follicles and prolong the anagen hair cycle. Apremilast, a phosphodiesterase 4 inhibitor, showed a significant improvement of extensive, refractory alopecia areata. Furthermore, apremilast significantly reduces TGF-b1-induced fibroblast migration and inhibits dermal fibroblast differentiation into myofibroblasts that is mediated by TGF-b1 in psoriatic patients. 7,8 TGF-b1 signalling is a critical driver of collagen accumulation and fibrotic diseases but also a vital suppressor of inflammation and epithelial cell proliferation. We agree with the hypothesis delivered by Chen et al., 1 and we thought that attenuating/ameliorating drugs of TGF-b1 signalling, and its pro-fibrotic activity, such as PDEI may represent a future hope for hair disorders. These drugs/agents can be useful alone or in combination as a therapeutic for disorders with perifollicular fibrosis, such as AGA. Chen et al.'s study, 1 though a preliminary, may pave the way to better understanding of AGA. Further research into drug-delivery, ideal topical concentration or oral dose and frequency, and side effects of these drugs is warranted. As per our speculation, PDEI drugs may be a promising therapy for AGA.

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“…Considering that it is generally well tolerated by the patients, apremilast is also used in other inflammatory conditions when conventional treatment induces too many side effects, proves to be unsuccessful or the patient is not eligible for other available drugs [ 3 , 4 ]. Alopecia areata, atopic dermatitis, hidradenitis suppurativa, cutaneous sarcoidosis and discoid lupus are examples of off-label prescribing [ 2 , 5 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Pseudotumor of the Larynx: A Previously Unreported Side Effect of Apremilast

Ntouniadakis

Landström

2020

Case Rep Dermatol

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Apremilast (Otezla®) is a relatively novel orally administered non-biologic disease-modifying anti-rheumatic drug (DMARD) extensively used in the management of psoriasis and psoriasis arthritis, lately approved for treating oral ulcerations in Behçets disease. Its advantageous side effect profile together with its uncomplicated follow-up and monitoring when compared to other DMARDs facilitates even a broad off-label prescribing. Here, the first case of laryngeal pseudotumor in a patient treated with apremilast for plaque psoriasis is presented.

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Apremilast in refractory alopecia areata

Cited by 13 publications

References 9 publications

Alopecia areata: a review on diagnosis, immunological etiopathogenesis and treatment options

Alopecia areata: a review on diagnosis, immunological etiopathogenesis and treatment options

Emergency Doctor's ability to diagnose Hidradenitis Suppurativa

Pseudotumor of the Larynx: A Previously Unreported Side Effect of Apremilast

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