European Expert Consensus Statement on the Systemic Treatment of Alopecia Areata

    January 2024 in “ JEADV. Journal of the European Academy of Dermatology and Venereology/Journal of the European Academy of Dermatology and Venereology ”
    Lidia Rudnicka, Monika Arenbergerová, Ramón Grimalt, Dimitrios Ioannidis, Alexander Katoulis, E. Lazaridou, Małgorzata Olszewska, Yuliya Ovcharenko, Bianca Maria Piraccini, Asja Prohić, Adriana Rakowska, P. Reygagne, M.‐A. Richard, Rui Oliveira Soares, Michela Starace, Sergio Vañó‐Galván, Anna Waśkiel‐Burnat
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    TLDR Baricitinib and ritlecitinib are recommended for severe alopecia areata, with other treatments available off-label.
    The European expert consensus statement on the systemic treatment of alopecia areata provides a comprehensive treatment algorithm for this autoimmune condition, which can range from limited hair loss to complete scalp and body hair loss. The consensus highlights the use of the Severity of Alopecia Tool (SALT) and the Alopecia Areata Scale (AAS) to evaluate disease severity, with a SALT score of 20 or higher indicating the need for systemic therapy. Currently, the only EMA-approved medications for severe alopecia areata are baricitinib for adults and ritlecitinib for individuals aged 12 and older. Other off-label systemic treatments include glucocorticosteroids, cyclosporine, methotrexate, and azathioprine, with oral minoxidil considered as an adjuvant therapy. The statement aims to guide the indications, efficacy, safety, and duration of systemic treatments for alopecia areata.
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