Cytokine-Targeting Biologic Therapies for Alopecia Areata: A Comprehensive Review of Mechanism of Action, Clinical Efficacy, and Adverse Events

This comprehensive review evaluates cytokine-targeting biologic therapies for alopecia areata (AA), highlighting the efficacy of therapies like dupilumab and ustekinumab, which target multiple cytokines and result in significant hair regrowth. Dupilumab achieved significant hair regrowth in 89% of cases, while ustekinumab showed promising results in all patients. In contrast, biologics targeting single cytokines, such as secukinumab and tralokinumab, show limited efficacy. The review underscores the need for further research to refine therapeutic strategies by identifying relevant cytokine targets and understanding the immunopathogenic pathways in AA. Safety profiles are generally favorable, but TNF antagonists pose higher risks of adverse reactions.