Extensive Alopecia Areata Is Reversed by IL-12/23p40 Cytokine Antagonism

The study investigated the effects of IL-12/23p40 cytokine antagonism on hair regrowth in 3 patients with extensive alopecia areata (AA), using 90mg ustekinumab administered subcutaneously. The patients, with AA involvement ranging from alopecia universalis (100% hair loss) to 40% hair loss, showed significant hair regrowth at 20 weeks, with improvements ranging from 25% to 85%. The patient with alopecia universalis achieved 97% regrowth by week 49. The treatment led to marked decreases in inflammatory markers and increases in hair-associated keratins. Greater baseline inflammation and suppression of hair keratins were linked to higher regrowth. The study suggested that targeting specific cytokines and inflammatory pathways could be a promising treatment for extensive AA.