Sequential Immunotherapy for Alopecia Areata: Phase-Driven Immune Rebalancing

November 2025 in “ Expert Review of Clinical Immunology ”

Yetan Shi, Xiuzu Song

alopecia areata sequential immunotherapy immune privilege immunomodulatory interventions immune homeostasis immunosuppression immune tolerance hair follicles inflammatory responses AA

Studysummary This review of sequential immunotherapy strategies for alopecia areata suggests that combining initial intensive immunosuppression with maintenance therapy may effectively manage disease progression by modulating inflammation and restoring immune tolerance.

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research Janus Kinase Inhibitors for Alopecia Areata: A Review of Clinical Data

4 citations , May 2025 in “Frontiers in Immunology”

This review examines the mechanisms of Janus kinase inhibitors in treating alopecia areata and evaluates their efficacy and safety, but reports no new clinical results.

research The Relative Efficacy and Safety of Monotherapies for Alopecia Areata: A Network Meta-Analysis Study

5 citations , April 2025 in “Journal of Cosmetic Dermatology”

This study evaluated eight JAK inhibitor regimens for alopecia areata and provided high-quality evidence on their comparative effectiveness, which can aid clinicians in decision-making and inform medical practice guidelines.

research Patterns of Clinical Response in Patients With Alopecia Areata Treated With Ritlecitinib in the Allegro Clinical Development Programme

13 citations , February 2025 in “Journal of the European Academy of Dermatology and Venereology”

Ritlecitinib shows promise for treating alopecia areata, especially with early and extended treatment.

research Alopecia Areata: Understanding the Pathophysiology and Advancements in Treatment Modalities

January 2025 in “Cureus”

This review highlights that alopecia areata is influenced by genetic, autoimmune, and environmental factors, with emerging treatments like JAK-2 inhibitors showing promise for severe cases.

research Pathogenesis and Regenerative Therapy in Vitiligo and Alopecia Areata: Focus on Hair Follicle

January 2025 in “Frontiers in Medicine”

This study reviews the role of hair follicles in the development, symptoms, and treatment options for vitiligo and alopecia areata, aiming to enhance understanding of their involvement in these autoimmune conditions and explore potential therapies.

Healthy Individuals Genetically At-Risk for the Development of Pemphigus Vulgaris or Alopecia Areata Share Disease-Like Cytokine Dysregulation

research Healthy Individuals Genetically At-Risk for the Development of Pemphigus Vulgaris or Alopecia Areata Share Disease-Like Cytokine Dysregulation

1 citations , January 2025 in “Frontiers in Immunology”

In this study, researchers found that cytokine dysregulation linked to genetic background is present in both patients and healthy but genetically related individuals in two autoimmune skin diseases, Pemphigus vulgaris and Alopecia areata, suggesting that protective immune mechanisms may prevent disease manifestation in predisposed individuals.

research Efficacy and Safety of the Oral Janus Kinase 3/Tyrosine Kinase Inhibitor Ritlecitinib Over 24 Months: Integrated Analysis of the ALLEGRO Phase IIb/III and Long-Term Phase III Clinical Studies in Alopecia Areata

23 citations , October 2024 in “British Journal of Dermatology”

In this study, ritlecitinib showed sustained effectiveness and a favorable safety profile in treating alopecia areata in patients aged 12 and older over 24 months, with improvements observed in hair and eyebrow regrowth and patient satisfaction.

research Innovative Strategies for the Discovery of New Drugs Against Alopecia Areata: Taking Aim at the Immune System

12 citations , October 2024 in “Expert Opinion on Drug Discovery”

This review discusses the current state of alopecia areata treatments, noting that while recent advances such as Janus Kinase inhibitors show promise, persistent challenges like limited efficacy, safety concerns, and patient compliance highlight the need for innovative drug discovery and development strategies.

research Efficacy and Safety of Deuruxolitinib, an Oral Selective Janus Kinase Inhibitor, in Adults with Alopecia Areata: Results from the Phase 3 Randomized, Controlled Trial (THRIVE-AA1)

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This study found that the oral JAK1/JAK2 inhibitor deuruxolitinib effectively promoted hair regrowth and patient satisfaction in adults with alopecia areata over 24 weeks.

research Long-Term Efficacy and Safety of Baricitinib in Patients With Severe Alopecia Areata: 104-Week Results From BRAVE-AA1 and BRAVE-AA2

February 2024 in “Journal of the European Academy of Dermatology and Venereology”

In this study, baricitinib for severe alopecia areata showed sustained efficacy over 104 weeks, with most Week-52 responders maintaining significant hair regrowth and some mixed responders improving further with long-term treatment.

research Comparative Efficacy of Oral Janus Kinase Inhibitors and Biologics in Adult Alopecia Areata: A Systematic Review and Bayesian Network Meta-Analysis

20 citations , January 2024 in “Journal of the European Academy of Dermatology and Venereology”

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This study developed a technique to limit genetic recombination to regulatory T cells to investigate whether self-tolerance is maintained in non-lymphoid tissues, an area previously not well understood.

research European Expert Consensus Statement on the Systemic Treatment of Alopecia Areata

4 citations , January 2024 in “JEADV. Journal of the European Academy of Dermatology and Venereology/Journal of the European Academy of Dermatology and Venereology”

This consensus statement outlines a treatment algorithm for alopecia areata, detailing systemic treatment indications and options, including EMA-approved medications baricitinib and ritlecitinib for severe cases, as well as other off-label treatments and adjuvant therapies like oral minoxidil.

research Inhibition of T-Cell Activity in Alopecia Areata: Recent Developments and New Directions

4 citations , November 2023 in “Frontiers in immunology”

In this narrative review, researchers outlined the role of T cells in the autoimmune pathogenesis of alopecia areata and highlighted ongoing research into therapeutic pathways, beyond current JAK inhibitors, aimed at developing new treatments for the disease.

research Alopecia Areata: Current Treatments and New Directions

57 citations , August 2023 in “American Journal of Clinical Dermatology”

JAK inhibitors and platelet-rich plasma show promise for treating alopecia areata.

Major Improvement of Very Severe Alopecia Areata in Patients Treated With the Combination of Baricitinib and Low Doses of Corticosteroids: An Eight-Case Series

research Major Improvement of Very Severe Alopecia Areata in Patients Treated With the Combination of Baricitinib and Low Doses of Corticosteroids: An Eight-Case Series

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In this study, combining baricitinib and prednisone effectively achieved complete hair regrowth in seven out of eight women with very severe alopecia areata, contrasting with less effective results from each drug used alone.

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research The Potential of Regulatory T Cell-Based Therapies for Alopecia Areata

May 2023 in “Frontiers in Immunology”

This article discusses the role of regulatory T cells in alopecia areata, where their deficiency in hair follicles may lead to impaired local immunity and suggests potential therapies like CAR-T reg cells and low-dose IL-2 to alleviate autoimmunity and promote hair regeneration in affected individuals.

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2 citations , April 2023 in “Expert Review of Clinical Immunology”

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This study found that dupilumab treatment in alopecia areata significantly suppressed Th2-related markers and increased hair keratin levels, suggesting a potential role of Th2 cytokines in the disease's pathogenesis.

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290 citations , August 2021 in “Clinical Reviews in Allergy & Immunology”

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research Efficacy of Different Concentrations of Intralesional Triamcinolone Acetonide for Alopecia Areata: A Systematic Review and Meta-Analysis

19 citations , December 2019 in “Journal of the American Academy of Dermatology”

This study suggests that intralesional triamcinolone acetonide at a concentration of 5 mg/mL may offer the best balance of effectiveness and safety for treating focal alopecia areata.

research IL-12/IL-23 Neutralization Is Ineffective for Alopecia Areata in Mice and Humans

20 citations , December 2019 in “The journal of allergy and clinical immunology/Journal of allergy and clinical immunology/The journal of allergy and clinical immunology”

In this study, ustekinumab did not promote hair regrowth in human patients with alopecia areata or prevent disease development in an AA mouse model, suggesting limited efficacy for this treatment.

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55 citations , October 2019 in “The journal of allergy and clinical immunology/Journal of allergy and clinical immunology/The journal of allergy and clinical immunology”

This review discusses emerging research areas in alopecia areata pathobiology, highlighting the potential roles of unconventional immune cells and the need for more targeted therapeutic strategies, but reports no new experimental results.

research The Effectiveness of Oral Mini-Pulse Methylprednisolone in the Treatment of Alopecia Areata in Vietnam

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In this study, oral mini-pulse methylprednisolone therapy for alopecia areata was reported to be effective and safe over 6 months, with 82.2% of patients recovering well and no adverse events observed.

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56 citations , January 2019 in “Lancet”

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148 citations , December 2018 in “Journal of autoimmunity”

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research The Changing Landscape of Alopecia Areata: The Therapeutic Paradigm

77 citations , June 2017 in “Advances in Therapy”

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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”

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research Hair Follicle-Derived IL-7 and IL-15 Mediate Skin-Resident Memory T Cell Homeostasis and Lymphoma

245 citations , October 2015 in “Nature medicine”

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159 citations , October 2015 in “Science Advances”

This study observed that applying JAK-STAT pathway inhibitors to mouse and human skin led to rapid hair growth by inducing the anagen phase of hair follicles.

research The Role of Lymphocytes in the Development and Treatment of Alopecia Areata

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This study suggests that CD8+ cytotoxic T lymphocytes play a crucial role in the development of alopecia areata, based on observations in rodent models that mimic human autoimmune disease.

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research Blocking Potassium Channels (Kv1.3): A New Treatment Option for Alopecia Areata?

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research Calcitonin Gene-Related Peptide (CGRP) May Award Relative Protection from Interferon-γ-Induced Collapse of Human Hair Follicle Immune Privilege

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