Cytokine-Targeted Treatment in Alopecia Areata - New Possibilities?

Alopecia areata is a challenging, recurrent form of non-scarring hair loss with an unclear etiology involving multiple immunological pathways and abnormal cytokine profiles. Traditional treatments, including corticosteroids and immunosuppressive drugs, have limited efficacy and potential side effects. Janus kinase inhibitors, while effective, may cause metabolic disorders. New cytokine-targeted therapies such as apremilast, ustekinumab, abatacept, secukinumab, and dupilumab have shown promise. However, TNF inhibitors and other agents like alefacept and efalizumab have proven ineffective, with some even exacerbating the condition. There are also isolated reports of alopecia areata following treatments with omalizumab, ixekizumab, and brodalumab.