Systemic Treatments for Alopecia Areata: A Systematic Review

This systematic review evaluated the evidence for systemic treatments for alopecia areata, alopecia totalis, and alopecia universalis by analyzing 16 randomized controlled trials (RCTs) with a total of 768 participants. The review found significant variability in treatment success definitions and noted that no study assessed the impact of treatments on quality of life using comprehensive quantitative instruments. Oral prednisolone pulse therapy and oral inosiplex showed some efficacy, while oral zinc sulfate, alefacept, and efalizumab were not supported by evidence. Adverse events were mostly corticosteroid-related but generally well tolerated. The review concluded that no specific systemic therapy had robust evidence from RCTs, and future studies should have clear clinical response endpoints to facilitate meta-analyses.