Reply: Alopecia areata treatment with simvastatin/ezetimibe

Lattouf, Carol; Schachner, Lawrence A.; Wikramanayake, Tongyu C.; Kittles, Carol; Tosti, Antonella; Miteva, Mariya; Jiménez, Joaquín J.; Herskovitz, Ingrid; Handler, Marc Z.; Fabbrocini, Gabriella

doi:10.1016/j.jaad.2015.10.024

Cited by 4 publications

(5 citation statements)

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“…Loi, et al conducted a small prospective study to examine simvastatin/ezetimibe treatment in patients with AA totalis/universalis, noting no benefit. A similarly small study by Lattouf, et al did, however, observe hair regrowth in a number of AA patients, in addition to possible prevention of relapse. Combination treatment involving simvastatin and ezetimibe remains, therefore, a potentially beneficial therapy for some AA patients.…”

Section: Modulation Of Cholesterol Homeostasis In the Hfmentioning

confidence: 99%

Cholesterol homeostasis: Links to hair follicle biology and hair disorders

Palmer

Blakeborough

Harries

et al. 2019

Experimental Dermatology

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Lipids and lipid metabolism are critical factors in hair follicle (HF) biology, and cholesterol has long been suspected of influencing hair growth. Altered cholesterol homeostasis is involved in the pathogenesis of primary cicatricial alopecia, mutations in a cholesterol transporter are associated with congenital hypertrichosis, and dyslipidaemia has been linked to androgenic alopecia. The underlying molecular mechanisms by which cholesterol influences pathways involved in proliferation and differentiation within HF cell populations remain largely unknown. As such, expanding our knowledge of the role for cholesterol in regulating these processes is likely to provide new leads in the development of treatments for disorders of hair growth and cycling. This review describes the current state of knowledge with respect to cholesterol homeostasis in the HF along with known and putative links to hair pathologies.

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Section: Modulation Of Cholesterol Homeostasis In the Hfmentioning

confidence: 99%

Cholesterol homeostasis: Links to hair follicle biology and hair disorders

Palmer

Blakeborough

Harries

et al. 2019

Experimental Dermatology

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“…Existing studies indicate that statins are not effective in chronic longstanding AA. This might be linked to their mechanism of action being prevention of IFN-g signaling and lymphocyte activation, which are more important targets in acute AA when inflammation is a more prominent feature (Alkhalifah et al, 2010;Lattouf et al, 2016). Experiments in the AA mouse model also indicate that intramuscular injections and topical application of statins can induce remission of disease and also prevent disease development.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Alopecia Areata with Simvastatin/Ezetimibe

Cervantes

Jiménez

DelCanto

et al. 2018

Journal of Investigative Dermatology Symposium Proceedings

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Alopecia areata (AA) is an autoimmune disorder characterized by T lymphocytic infiltrates around the bulbar region of hair follicles. Statins have surfaced as potential therapeutic agents for AA, partly because of their modulation of the JAK/STAT pathway. Some data indicate that statins are a possible option for acute, but not chronic, longstanding AA. Animal studies suggest that treatment with statins increases CD4/CD25/Foxp3 populations in AA-affected mice.

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“…In reply, Lattouf et al [13] argued that it is not completely surprising that statins should not be effective in patients with long-standing severe alopecia areata, since statins' immunological mechanism of action is more directed in preventing interferon-γ signaling and lymphocyte activation, which represent a more important target in acute alopecia areata. Statins were allegedly shown to prevent alopecia areata in a mouse model, and a similar preventive effect has been reported in a mouse model of vitiligo [17].…”

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%

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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Reply: Alopecia areata treatment with simvastatin/ezetimibe

Cited by 4 publications

References 1 publication

Cholesterol homeostasis: Links to hair follicle biology and hair disorders

Cholesterol homeostasis: Links to hair follicle biology and hair disorders

Treatment of Alopecia Areata with Simvastatin/Ezetimibe

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

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