Treatment of Chronic Alopecia Areata With Tildrakizumab: An Open-Label Pilot Study

In an open-label pilot study, tildrakizumab, a monoclonal antibody targeting interleukin (IL)-23, was tested for its efficacy in treating chronic alopecia areata (AA), a condition for which there are no reliably effective evidence-based treatments. Nine patients with moderate to severe AA, who were refractory to other systemic therapies, received three doses of tildrakizumab. At week 28, two patients showed a partial response, while the remaining seven showed no regrowth. Mild adverse effects included upper respiratory tract infection and acne. The study's limitations included a small sample size, lack of a control group, and inclusion of only patients who were refractory to multiple other therapies. The authors suggest that adequately powered, randomized, placebo-controlled, dose-ranging trials are needed to further examine the efficacy of tildrakizumab in AA.