New Therapies for Alopecia Areata

October 2021 in “ Bőrgyógyászati és Venerológiai Szemle ”

Adriána Evelin Csernus, Rolland Gyulai

alopecia areata pathomechanism therapeutic strategies European Medicines Agency treatment protocols

TLDR New treatments for severe alopecia areata show promise but lack standard approval.

The document discussed advancements in understanding the pathomechanism of alopecia areata, which led to new treatment opportunities that could potentially revolutionize therapeutic strategies for this unpredictable and heterogeneous disease. Despite the significant impact on quality of life, there were no standardized treatment protocols approved by the European Medicines Agency (EMA) at the time, posing challenges for therapists in selecting appropriate treatments. The paper summarized recent and emerging therapies specifically for severe cases of alopecia areata.

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Efficacy and Safety of the Oral Janus Kinase Inhibitor Baricitinib in the Treatment of Adults with Alopecia Areata: Phase 2 Results from a Randomized Controlled Study

research Efficacy and Safety of the Oral Janus Kinase Inhibitor Baricitinib in the Treatment of Adults with Alopecia Areata: Phase 2 Results from a Randomized Controlled Study

66 citations , June 2021 in “Journal of The American Academy of Dermatology”

Baricitinib is effective and safe for treating severe alopecia areata.

research A Comprehensive Literature Review of JAK Inhibitors in the Treatment of Alopecia Areata

40 citations , June 2021 in “Clinical, cosmetic and investigational dermatology”

JAK inhibitors show promise in effectively treating hair loss from alopecia areata.

research A Phase 2a Randomized, Placebo-Controlled Study to Evaluate the Efficacy and Safety of the Oral Janus Kinase Inhibitors Ritlecitinib and Brepocitinib in Alopecia Areata: 24-Week Results

138 citations , March 2021 in “Journal of the American Academy of Dermatology”

Ritlecitinib and brepocitinib effectively regrow hair in alopecia areata patients.

research Rapidly Progressive Alopecia Areata Totalis in a COVID-19 Patient, Unresponsive to Tofacitinib

14 citations , February 2021 in “Journal of the European Academy of Dermatology and Venereology”

A COVID-19 patient with severe hair loss did not improve with hair loss medication after stopping and restarting it due to the infection.

research Hair Follicle Immune Privilege and Its Collapse in Alopecia Areata

134 citations , July 2020 in “Experimental dermatology”

Hair follicles are normally protected from the immune system, but when this protection fails, it can cause hair loss in alopecia areata.

research New and Emerging Therapies for Alopecia Areata

46 citations , April 2020 in “Drugs”

Emerging therapies like JAK inhibitors show promise for hair regrowth in alopecia areata.

research Italian Guidelines in Diagnosis and Treatment of Alopecia Areata

37 citations , December 2019 in “Giornale italiano di dermatologia e venereologia”

The Italian guidelines offer advice for diagnosing and treating alopecia areata based on expert opinion and limited clinical trial evidence.

research Scoping Review on the Use of Drugs Targeting JAK/STAT Pathway in Atopic Dermatitis, Vitiligo, and Alopecia Areata

55 citations , October 2019 in “Dermatology and therapy”

Drugs targeting the JAK/STAT pathway can improve atopic dermatitis but vary in effectiveness for vitiligo and alopecia areata, with generally mild safety concerns.

research Alopecia Areata in 2 Patients Treated with Dupilumab: New Onset and Worsening

26 citations , July 2019 in “JAAD Case Reports”

Dupilumab for atopic dermatitis may cause new or worsen existing alopecia areata.

research Alopecia Areata Predictive Score: A New Trichoscopy-Based Tool to Predict Treatment Outcome in Patients with Patchy Alopecia Areata

19 citations , July 2019 in “Journal of Cosmetic Dermatology”

A new tool can predict hair regrowth in patchy alopecia areata patients.

research JAK Inhibitors for Alopecia Areata: A Systematic Review and Meta-Analysis

130 citations , February 2019 in “JEADV. Journal of the European Academy of Dermatology and Venereology/Journal of the European Academy of Dermatology and Venereology”

JAK inhibitors are effective for treating alopecia areata, with most patients seeing hair growth after treatment.

research JAK Inhibitors and Alopecia Areata

56 citations , January 2019 in “Lancet”

JAK inhibitors help regrow hair in alopecia areata patients, improving their quality of life.

research Janus Kinase Inhibitors for the Treatment of Severe Alopecia Areata: An Open-Label Comparative Study

66 citations , December 2018 in “Dermatology”

Both ruxolitinib and tofacitinib are effective and safe for treating severe alopecia areata, but relapses are common.

research Drug-Induced Alopecia After Dupilumab Therapy

49 citations , December 2018 in “JAAD case reports”

Dupilumab may cause significant hair loss, which can reverse after stopping the drug.

research Treatment of Alopecia Areata: An Australian Expert Consensus Statement

95 citations , November 2018 in “Australasian journal of dermatology”

Alopecia areata treatment varies, with no optimal method established yet.

research Response to Ustekinumab in Three Pediatric Patients with Alopecia Areata

25 citations , October 2018 in “Pediatric dermatology”

Ustekinumab helped three kids with alopecia areata regrow hair.

research Role of Janus Kinase Inhibitors in the Treatment of Alopecia Areata

53 citations , July 2018 in “Drug design, development and therapy”

Janus kinase inhibitors show promise in treating alopecia areata but need better topical formulations.

research Efficacy of Diphenylcyclopropenone in Alopecia Areata: A Comparison of Two Treatment Regimens

10 citations , January 2018 in “Postępy Dermatologii i Alergologii”

Treating alopecia areata every 3 weeks with diphenylcyclopropenone is more effective than weekly treatments.

research Tofacitinib 2% Ointment, a Topical Janus Kinase Inhibitor, for the Treatment of Alopecia Areata: A Pilot Study of 10 Patients

48 citations , November 2017 in “Journal of the American Academy of Dermatology”

Tofacitinib 2% ointment helped hair regrow in 3 out of 10 patients with alopecia areata, but caused side effects like scalp irritation and raised cholesterol in some.

research Efficacy of Topical Tofacitinib in Promoting Hair Growth in Non-Scarring Alopecia: Possible Mechanism via VEGF Induction

27 citations , September 2017 in “Archives of Dermatological Research”

Topical tofacitinib may grow hair better than minoxidil by increasing VEGF and reducing inflammation.

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99 citations , July 2017 in “Clinical Reviews in Allergy & Immunology”

New treatments for Alopecia Areata show promise but need to be more effective and affordable.

research Alopecia Areata: An Update on Treatment Options for Children

21 citations , May 2017 in “Paediatric drugs”

Individualized treatment plans are crucial for children with alopecia areata, with promising options like JAK inhibitors showing significant hair regrowth.

research The Role of Micronutrients in Alopecia Areata: A Review

63 citations , May 2017 in “American Journal of Clinical Dermatology”

People with alopecia areata often have lower levels of vitamin D, zinc, and folate, but more research is needed to understand if supplements can help treat it.

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44 citations , April 2017 in “International Journal of Dermatology”

No treatment is completely effective for alopecia totalis and alopecia universalis.

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355 citations , January 2017 in “Journal of the American Academy of Dermatology”

JAK inhibitors show promise for treating skin conditions like eczema, hair loss, and psoriasis.

research Topical Ruxolitinib for the Treatment of Alopecia Universalis

96 citations , December 2015 in “JAMA dermatology”

Topical Ruxolitinib may safely treat severe hair loss.

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

68 citations , November 2015 in “The Journal of Allergy and Clinical Immunology”

Blocking IL-12/IL-23p40 helped reverse severe hair loss in patients.

research Alopecia Areata Profiling Shows TH1, TH2, and IL-23 Cytokine Activation Without Parallel TH17/TH22 Skewing

176 citations , August 2015 in “The journal of allergy and clinical immunology/Journal of allergy and clinical immunology/The journal of allergy and clinical immunology”

Alopecia areata involves immune activation in the scalp, suggesting treatments targeting TH1, TH2, and IL-23 pathways.

research Reversal of Alopecia Areata Following Treatment With the JAK1/2 Inhibitor Baricitinib

184 citations , February 2015 in “EBioMedicine”

A patient with Alopecia Areata had complete hair regrowth after using the drug baricitinib.

research Alopecia Areata in the Elderly: A 10-Year Retrospective Study

9 citations , January 2015 in “Annals of dermatology/Annals of Dermatology”

Alopecia areata in elderly people is usually mild and responds well to treatment.

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185 citations , June 2014 in “Journal of Investigative Dermatology”

A man with severe hair loss and skin disease regrew his hair with no side effects after taking tofacitinib.

A Randomized, Double-Blind, Placebo- and Active-Controlled, Half-Head Study to Evaluate the Effects of Platelet-Rich Plasma on Alopecia Areata

research A Randomized, Double-Blind, Placebo- and Active-Controlled, Half-Head Study to Evaluate the Effects of Platelet-Rich Plasma on Alopecia Areata

205 citations , April 2013 in “British Journal of Dermatology”

Platelet-rich plasma treatment significantly increased hair regrowth and decreased discomfort in alopecia patients, making it a potentially better and safer treatment option.

research British Association of Dermatologists’ Guidelines for the Management of Alopecia Areata 2012

218 citations , April 2012 in “British Journal of Dermatology”

Guidelines suggest various treatments for alopecia areata, but leaving it untreated is also an option as 80% cases may recover on their own.