Treatment of alopecia areata with simvastatin/ezetimibe

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

doi:10.1016/j.jaad.2014.11.006

Cited by 55 publications

(44 citation statements)

References 3 publications

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“…Subsequently, Ali and Martin [16] reported 2 patients with treatment-refractory alopecia that benefited significantly from treatment with simvastatin/ezetimibe in addition to the continuation of intralesional corticosteroid injections. Ultimately, Lattouf et al [11] performed a prospective pilot study to evaluate the potential efficacy of simvastatin/ezetimibe (Vytorin; Merck and Co., Kenilworth, NJ, USA) 40/10 mg daily in patients with alopecia areata and reported a statistically significant association between being on therapy and stable remission of the disease. A total of 29 alopecia areata patients with 40-70% scalp involvement were enrolled: 19 patients completed 24 weeks of treatment, the remaining 10 patients were lost to follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…After having acknowledged the report of Lattouf et al [11] on the efficacy of simvastatin/ezetimibe, we offered the respective therapy off label to patients with alopecia areata who had previously undergone treatment without satisfying results. …”

Section: Methodsmentioning

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: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

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 a prospective uncontrolled study, simvastatin/ezetimibe 40 mg/10 mg daily for 24 weeks was shown to be an effective treatment option for alopecia areata [78].…”

Section: Simvastatin/ezetimibementioning

confidence: 99%

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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“…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].…”

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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Treatment of alopecia areata with simvastatin/ezetimibe

Cited by 55 publications

References 3 publications

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

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

Alopecia Areata

New Modalities in the Treatment of Refractory Alopecia Areata

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