Alopecia areata : An appraisal of new treatment approaches and overview of current therapies - 13/12/17

Doi : 10.1016/j.jaad.2017.04.1142

Lauren C. Strazzulla, BA ^a, Eddy Hsi Chun Wang, PhD ^b, Lorena Avila, MD ^a, Kristen Lo Sicco, MD ^a, Nooshin Brinster, MD ^a, Angela M. Christiano, PhD ^b, Jerry Shapiro, MD ^a,^⁎
^a The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
^b Department of Dermatology, College of Physicians and Surgeons, Columbia University, New York, New York

^∗Correspondence to: Jerry Shapiro, MD, Department of Dermatology, New York University School of Medicine, 530 First Ave, Unit 7R, New York, NY 10016.Department of Dermatology, New York University School of Medicine530 First Ave, Unit 7RNew YorkNY10016

Abstract

Many therapies are available for the treatment of alopecia areata, including topical, systemic, and injectable modalities. However, these treatment methods produce variable clinical outcomes and there are no currently available treatments that induce and sustain remission. When making management decisions, clinicians must first stratify patients into pediatric versus adult populations. Disease severity should then be determined (limited vs extensive) before deciding the final course of therapy. The second article in this continuing medical education series describes the evidence supporting new treatment methods, among them Janus kinase inhibitors. We evaluate the evidence concerning the efficacy, side effects, and durability of these medications. An overview of conventional therapy is also provided with new insights gleaned from recent studies. Finally, future promising therapeutic options that have not yet been fully evaluated will also be presented.

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Key words : alopecia areata, alopecia totalis, alopecia universalis, corticosteroids, JAK inhibitors, minoxidil, topical immunotherapy

Abbreviations used : AA, AT, AU, DPCP, JAK, SADBE, SALT, TAC

Plan

Approach to treatment

Intralesional corticosteroids

Topical corticosteroids

Minoxidil

Oral corticosteroids

Methotrexate

Topical immunotherapy

Novel therapeutic method using Janus kinase inhibitors

Future directions

	Funding sources: None.
	Dr Shapiro is a consultant for Aclaris Therapeutics, Applied Biology, Incyte, Replicel Life Sciences, and Samumed. Dr Christiano is a consultant for Aclaris Therapeutics and a principal investigator for Pfizer. The other authors have no conflicts of interest to declare.
	Ms Strazzulla and Dr Wang contributed equally to this article.
	Date of release: January 2018
	Expiration date: January 2021