Interventions for alopecia areata

Delamere, Finola M; Sladden, Michael J; Dobbins, Helen M; Leonardi‐Bee, Jo

doi:10.1002/14651858.cd004413.pub2

Cited by 161 publications

(135 citation statements)

References 49 publications

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“…Persistent moderate-to-severe AA causes significant disfigurement and psychological distress in affected individuals (3). In clinical practice, there are no evidence-based treatments for AA (4), yet various treatments are offered, most commonly topical and intralesional steroids, which have limited efficacy.…”

Section: Introductionmentioning

confidence: 99%

Oral ruxolitinib induces hair regrowth in patients with moderate-to-severe alopecia areata

Mackay‐Wiggan¹,

Jabbari²,

Nguyen³

et al. 2016

JCI Insight

222

193

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IntroductionAlopecia areata (AA) is a major medical problem and is among the most prevalent autoimmune disease in the US, with a lifetime risk of 1.7% (1). AA affects both sexes across all ethnicities and represents the second most common form of human hair loss, second only to androgenetic alopecia (2). AA usually presents with patchy hair loss. One-third of these patients will experience spontaneous remissions within the first year. However, many patients' disease will progress to alopecia totalis (AT, total scalp hair loss) or alopecia universalis (AU, loss of all body hair). Persistent moderate-to-severe AA causes significant disfigurement and psychological distress in affected individuals (3). In clinical practice, there are no evidence-based treatments for AA (4), yet various treatments are offered, most commonly topical and intralesional steroids, which have limited efficacy.Our recent mechanistic studies demonstrated a dominant role for type I cellular immunity in AA pathogenesis, mediated by IFN-γ-producing NKG2D-bearing CD8 + cytotoxic T lymphocytes (CTLs) (5). The central role of type I cellular immunity is also reflected in the transcriptional landscape of AA lesional skin in humans and mice, which is dominated by IFN response genes and a CTL signature. These findings provided BACKGROUND. Alopecia areata (AA) is a common autoimmune disease with a lifetime risk of 1.7%; there are no FDA-approved treatments for AA. We previously identified a dominant IFN-γ transcriptional signature in cytotoxic T lymphocytes (CTLs) in human and mouse AA skin and showed that treatment with JAK inhibitors induced durable hair regrowth in mice by targeting this pathway. Here, we investigated the use of the oral JAK1/2 inhibitor ruxolitinib in the treatment of patients with moderate-to-severe AA.

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Section: Introductionmentioning

confidence: 99%

Oral ruxolitinib induces hair regrowth in patients with moderate-to-severe alopecia areata

Mackay‐Wiggan¹,

Jabbari²,

Nguyen³

et al. 2016

JCI Insight

222

193

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“…Midpotent and potent topical corticosteroids in forms of lotions, creams, and ointments are widely used in spite of the fact that evidence of their effectiveness is limited [42,43]. In a double-blind placebo-controlled study, rate of complete hair growth was not statistically significant with 12 weeks use of 0.25% desoximetasone cream, twice daily, when compared with placebo [44].…”

Section: Topical Corticosteroidsmentioning

confidence: 98%

Alopecia Areata

Engın¹,

Oba²,

Tüzün³

2017

Hair and Scalp Disorders

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Alopecia areata is an organ-specific autoimmune disease targeting hair follicles. It causes nonscarring hair loss. The prevalence rate of the disease is approximately 1 in 1000 people worldwide. The condition is most commonly seen as circular areas of hair loss, but it may sometimes be as extensive as to involve the whole scalp or whole body. The complex pathophysiology of alopecia areata involves an autoimmune basis. Association of alopecia areata with other autoimmune diseases, such as thyroiditis and vitiligo, and the good response of patients to immunosuppressive treatment support an autoimmune etiology. Although some poor prognostic signs are defined, the course of the disease is unpredictable and the response to treatment can be variable. To date, there are neither preventive nor curative measures to deal with the condition. First-line therapy for patchy disease is topical and intralesional steroids, whereas extensive disease is conventionally managed with immunotherapy. New treatment agents, such as excimer laser, low-dose recombinant interleukin 2, Janus kinase inhibitors, and simvastatin/ezetimibe, are promising.

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“…Curative therapy does not exist, and there is a paucity of well-conducted, long-term, controlled trials evaluating the efficacy of therapy and its effect on the quality of life. 20 Poor prognostic factors include bald patches persisting for more than 1 year, onset or aggravation of hair loss before puberty, positive family history of AA, ophiasis pattern of involvement, associated nail changes, atopy, autoimmune disorders, and Down syndrome.…”

Section: Treatmentmentioning

confidence: 99%

“…20 Spontaneous remission occurs in 80% of patients with AA within 1 year, and not all patients require intense therapy. Therefore, watchful observation is also a therapeutic option.…”

mentioning

confidence: 99%

Alopecia Areata: An Update

Jerajani¹,

Rohatgi²,

Agrawal³

2017

MGM Journal of Medical Sciences

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Alopecia areata (AA) is a very common autoimmune disease that leads to unpredictable, relapsing patchy hair loss. Its chronic pathophysiology is still not fully understood. Hair follicles are not destroyed permanently due to which the potential for regrowth of hair is retained for many years, and is possibly lifelong. Clinical presentation varies from small alopecia patches most commonly on the scalp to full body involvement. Characteristic "swarm of bees" appearance on histopathology is confirmatory in acute cases. A variety of therapeutic options are available, but search for new modalities continues as there is a high relapse rate and a number of side effects associated with the available treatment options.

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Interventions for alopecia areata

Cited by 161 publications

References 49 publications

Oral ruxolitinib induces hair regrowth in patients with moderate-to-severe alopecia areata

Oral ruxolitinib induces hair regrowth in patients with moderate-to-severe alopecia areata

Alopecia Areata

Alopecia Areata: An Update

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