High-Dose Pulse Corticosteroid Therapy in the Treatment of Severe Alopecia areata

Seiter, Simone; Ugurel, Selma; Tilgen, Wolfgang; Reinhold, Uwe

doi:10.1159/000051642

Cited by 61 publications

(90 citation statements)

References 15 publications

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“…These data are basically consistent with the reported efficacy and side effects of pulsed corticosteroid therapy [23, 25,28,29,30]. The major concern with this pulsed administration of corticosteroid, either orally or intramuscularly, is how to suppress the recurrence.…”

Section: Discussionsupporting

confidence: 87%

A Comparison of the Efficacy, Relapse Rate and Side Effects among Three Modalities of Systemic Corticosteroid Therapy for Alopecia Areata

et al. 2006

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Background: Systemic corticosteroids are one of the most commonly used therapeutic modalities for patients with extensive alopecia areata (AA), although they entail several drawbacks. Objective: To determine the best modality for systemic corticosteroid use in terms of their efficacy, relapse rate, and side effects. Methods: Fifty-one patients with single or multiple AA (AA/multiplex) and 38 patients with alopecia totalis or AA universalis (AA totalis/universalis) were enrolled in this open study. They were randomly divided into three groups depending on the time of their initial visit. They were administered (1) oral dexamethasone (Dex) 0.5 mg/day for 6 months (Dex group), (2) intramuscular triamcinolone acetonide (imTA) 40 mg once a month for 6 months followed by 40 mg once every 1.5 months for 1 year (imTA group), and (3) pulse therapy (PT) using oral predonine 80 mg for 3 consecutive days once every 3 months (PT group). After the treatment, each treatment modality was evaluated by the response rate, relapse rate, and side effect profile. Results: The response rate of AA/multiplex was significantly better in the imTA group than in the Dex group. The overall relapse rate and that of AA totalis/universalis were significantly better in the PT group than in the Dex group. Dysmenorrhea was the most common and problematic side effect. Impairment of the adrenocortical reserve was seen in 7% of the PT group and 23% of the imTA group, which was recov ered without any further medical treatment. Conclusion: imTA or pulse therapy is effective for AA and has an acceptable level of side effects. The development of a new strategy to reduce the relapse rate is needed.

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Section: Discussionsupporting

confidence: 87%

A Comparison of the Efficacy, Relapse Rate and Side Effects among Three Modalities of Systemic Corticosteroid Therapy for Alopecia Areata

et al. 2006

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“…4). The relapse rate of 16.7% in our study is comparable to previous reports [6, 9,11,12,13]. As this is an open study, the results may have some biases.…”

Section: Discussionsupporting

confidence: 84%

“…The dosage of pulse therapy for AA varies from oral 80-mg to intravenous 2-gram administration of prednisolone per day [6,7,8,9,10,11,12,13]. According to the recent reports, the dosage of pulse corticosteroids commonly used in treating AA is 500 mg/day or 8 mg/kg/day of intravenous methylprednisolone for 3 consecutive days [8,10,11,12]. Lower dosage of oral prednisolone is also used in other studies [7, 9, 13].…”

Section: Introductionmentioning

confidence: 99%

Pulse Corticosteroid Therapy for Alopecia Areata: Study of 139 Patients

Nakajima

Inui

Itami³

2007

Dermatology

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Background/Aim: Recent reports of pulse corticosteroid therapy for alopecia areata (AA) show its efficacy for patients with a history of ≤1 year but not for recalcitrant cases or alopecia totalis/universalis. The purpose of this study was to evaluate the efficacy and safety of pulse corticosteroid therapy for recent-onset AA patients. Method: A total of 139 severe AA patients aged >15 years were included in this study. The duration from the onset of active hair loss was within 12 months for 125 (89.9%) of those patients. Results: Of the patients, 72.7% had hair loss on >50% of their scalp area. Among the recent-onset group (duration of AA ≤6 months), 59.4% were good responders (>75% regrowth of alopecia lesions), while 15.8% with >6 months duration showed a good response. Recent-onset AA patients with less severe disease (≤50% hair loss) responded at a rate of 88.0%, but only 21.4% of recent-onset patients with 100% hair loss responded. No serious adverse effects were observed.

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“…In patients with ophiasis AA and AA totalis and universalis the results were less encouraging. Seiter et al 25 treated 30 patients with 8 mg/kg intravenous methyl prednisolone on three consecutive days at 4-week intervals for at least three courses, 67% of patients with multifocal AA showed more than 50% hair regrowth. None of the patients with AA totalis or universalis and only one patient with ophiasis responded to therapy.…”

Section: Resultsmentioning

confidence: 99%