The Development of Universal Alopecia During Therapy With TNF-α Inhibitors in Patients With Ankylosing Spondylitis: Description of Three Cases

October 2021 in “ Rheumatology Science and Practice ”

M. V. Aristova, Е. М. Agafonova, A. E. Dimitreva, К. V. Sakharova, С. О. Красненко, Ш. Ф. Эрдес

universal alopecia alopecia areata TNF-α inhibitors pro-inflammatory cytokines

Studysummary The article presents three clinical cases of universal alopecia developing during TNF-α inhibitor therapy and discusses possible mechanisms and the role of pro-inflammatory cytokines. Our plain-language summary of this paper — not a Tressless recommendation.

The document described three clinical cases where patients with ankylosing spondylitis developed universal alopecia (UA) during therapy with TNF-α inhibitors. Universal alopecia is a severe form of alopecia areata, characterized by complete hair loss across the body. The study explored potential mechanisms behind this condition, highlighting the involvement of pro-inflammatory cytokines. This suggested that TNF-α inhibitors, while used to treat certain autoimmune conditions, might trigger or exacerbate hair loss in some patients.

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research Pathomechanisms of Immune-Mediated Alopecia

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This review discusses the mechanisms behind alopecia areata and primary cicatricial alopecia and reports no new clinical results, aiming to guide the development of targeted treatments.

research Alopecia Areata: A Review of Disease Pathogenesis

191 citations , May 2018 in “British journal of dermatology/British journal of dermatology, Supplement”

This study reviewed recent theories on alopecia areata's pathogenesis, highlighting its autoimmune nature due to immune privilege disruption in hair follicles, and noted current treatments have limited efficacy with high relapse rates, underscoring the need for further research into its mechanisms for better therapies.

research Alopecia Universalis Under Adalimumab Therapy in a Patient with Rheumatoid Arthritis

6 citations , May 2018 in “Zeitschrift für Rheumatologie”

This case report describes a 56-year-old woman with rheumatoid arthritis who developed alopecia universalis during treatment with the TNF inhibitor adalimumab, with no hair regrowth after stopping the medication.

research Alopecia Areata: Overview and Insights from January 2018

290 citations , December 2017 in “Journal of The American Academy of Dermatology”

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research Tofacitinib for the Treatment of Severe Alopecia Areata and Variants: A Study of 90 Patients

238 citations , November 2016 in “Journal of The American Academy of Dermatology”

In this study, tofacitinib was reported to improve scalp hair regrowth in patients with severe alopecia areata, alopecia totalis, and alopecia universalis, showing a higher response in alopecia areata.

research Alopecia Universalis Successfully Treated With Adalimumab

37 citations , October 2014 in “JAMA dermatology”

This case report describes a woman with alopecia universalis, resistant to multiple treatments, who experienced successful hair regrowth with adalimumab, suggesting potential mechanisms for future investigation.

research Alopecia Areata Is Driven by Cytotoxic T Lymphocytes and Is Reversed by JAK Inhibition

701 citations , August 2014 in “Nature medicine”

This study found that JAK inhibitors promote hair regrowth in both mice and human alopecia areata cases by blocking key immune pathways involved in disease development.

research Alopecia Areata: A Possible Extraintestinal Manifestation of Crohn's Disease

33 citations , June 2012 in “Journal of Crohn's and colitis”

This review discusses the role of immune responses, especially Th1 cytokines, in alopecia areata pathogenesis and reports no new research findings.

research Alopecia Areata as Another Immune-Mediated Disease Developed in Patients Treated with Tumor Necrosis Factor-Alpha Blocker Agents

61 citations , June 2010 in “Journal of the European Academy of Dermatology and Venereology”

This study highlights cases of alopecia areata that developed during anti-TNF-α therapy, suggesting a potential link or increased frequency, particularly among individuals with a personal or family history of autoimmune diseases.

research Alopecia Areata Update

391 citations , January 2010 in “Journal of The American Academy of Dermatology”

This article reviews the clinical presentation and histopathologic features of alopecia areata and proposes a hypothesis for its development, but it reports no new clinical results.

research Profile of Alopecia Areata: A Questionnaire Analysis of Patients and Families

161 citations , March 1992 in “International Journal of Dermatology”

This study analyzed survey responses from 800 alopecia areata patients and found a possible genetic association with increased insulin-dependent diabetes mellitus in relatives but not in the patients themselves.