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The Alopecia Areata Consensus of Experts (ACE) study: Results of an international expert opinion on treatments for alopecia areata - 19/06/20

Doi : 10.1016/j.jaad.2020.03.004 
Nekma Meah, MBChB, MRCP (UK) a, Dmitri Wall, MBBCh, BAO, MRCP a, Katherine York, MBBCh, FCDerm (SA) b, Bevin Bhoyrul, MBBS, MRCP (UK) a, Laita Bokhari, MPhil Med a, Daniel Asz Sigall, MD c, Wilma F. Bergfeld, MD d, Regina C. Betz, MD e, Ulrike Blume-Peytavi, MD f, Valerie Callender, MD g, Vijaya Chitreddy, FACD a, Andrea Combalia, MD h, George Cotsarelis, MD i, Brittany Craiglow, MD j, Jeff Donovan, MD, PhD k, Samantha Eisman, MBChB, MRCP, FACD a, Paul Farrant, MBBS, BSc, MRCP l, Jack Green, FACD m, Ramon Grimalt, MD, PhD n, Matthew Harries, PhD, FRCP o, Maria Hordinsky, MD, FAAD p, Alan D. Irvine, MD, DSc q, Satoshi Itami, MD, PhD r, Victoria Jolliffe, MA(Cantab), FRCP, FRCS(Ed), MRCGP, SFHEA s, Brett King, MD, PhD t, Won-Soo Lee, MD, PhD u, Amy McMichael, MD v, Andrew Messenger, MD, FRCP w, Paradi Mirmirani, MD x, Elise Olsen, MD y, Seth J. Orlow, MD, PhD z, aa, Bianca Maria Piraccini, MD, PhD bb, Adriana Rakowska, MD cc, Pascal Reygagne, MD dd, Janet L. Roberts, MD ee, Lidia Rudnicka, MD, PhD cc, Jerry Shapiro, MD, FAAD z, Pooja Sharma, MBBS, FACD a, Antonella Tosti, MD ff, Annika Vogt, MD gg, Martin Wade, FACD hh, Leona Yip, MBChB, PhD, FACD ii, Abraham Zlotogorski, MD jj, Rodney Sinclair, MBBS, MD, FACD a,
a Sinclair Dermatology, East Melbourne, Melbourne, Australia 
b Netcare Greenacres Hospital, Port Elizabeth, South Africa 
c Dermalomas Clinic, Mexico City, Mexico 
d Departments of Dermatology and Pathology, Cleveland Clinic, Cleveland, Ohio 
e Institute of Human Genetics, School of Medicine & University Hospital Bonn, University of Bonn, Bonn, Germany 
f Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Charité–Universitätsmedizin Berlin, Berlin, Germany 
g Howard University College of Medicine, Washington, DC 
h Department of Dermatology, Hospital Clinic de Barcelona, Barcelona, Spain 
i Department of Dermatology University of Pennsylvania School of Medicine Philadelphia, Philadelphia, Pennsylvania 
j Dermatology Physicians of Connecticut, Fairfield, Connecticut 
k Donovan Hair Clinic, Whistler, Canada 
l Brighton and Sussex University Hospitals Trust, Brighton, United Kingdom 
m St. Vincent's Hospital, Melbourne, Australia 
n Facultat de Medicina i Ciències de la Salut, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain 
o Department of Dermatology, Salford Royal NHS Foundation Trust, Manchester, United Kingdom 
p Dermatology, M Health Fairview Discovery Pediatric Specialty Clinic, Minneapolis, Minnesota 
q St. James's Hospital and National and International Sin Registry (NISR) Solutions, Dublin, Ireland 
r Department of Dermatology, Oita University, Yufu City, Japan 
s Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom 
t Yale School of Medicine, Yale Dermatology, Middlebury, Connecticut 
u Department of Dermatology Yonsei University Wonju College of Medicine, Wonju, Republic of Korea 
v Department of Dermatology, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina 
w Department of Infection, Immunity, and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom 
x The Permanente Medical Group, Vallejo, California 
y Duke Dermatology Clinic, Durham, North Carolina 
z Director of Pediatric Dermatology, The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York 
aa Department of Pediatrics, New York University Medical Center, New York, New York 
bb Deputy for International Relations, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy 
cc Department of Dermatology, Medical University of Warsaw, Warsaw, Poland 
dd Cabinet Pascal Reygagne (Lecourbe), Paris, France 
ee Northwest Dermatology Institute, Portland, Oregon 
ff Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida 
gg Department of Dermatology, Venerology and Allergology, Charité Universitätsmedizin Berlin, Berlin, Germany 
hh The London Skin and Hair Clinic, London, United Kingdom 
ii Gabba Dermatology, Brisbane, Australia 
jj Faculty of Medicine, Department of Dermatology, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel 

Rodney Sinclair, MBBS, MD, FACD, Sinclair Dermatology, 2 Wellington Parade, East Melbourne, Victoria 3002, Australia.Sinclair Dermatology2 Wellington ParadeEast MelbourneVictoria3002Australia

Abstract

Background

A systematic review failed to identify any systemic therapy used in alopecia areata (AA) where use is supported by robust evidence from high-quality randomized controlled trials.

Objective

To produce an international consensus statement on the use and utility of various treatments for AA.

Methods

Fifty hair experts from 5 continents were invited to participate in a 3-round Delphi process. Agreement of 66% or greater was considered consensus.

Results

In the first round, consensus was achieved in 22 of 423 (5%) questions. After a face-to-face meeting in round 3, overall, consensus was achieved for only 130 (33%) treatment-specific questions. There was greater consensus for intralesional treatment of AA (19 [68%]) followed by topical treatment (25 [43%]). Consensus was achieved in 45 (36%) questions pertaining to systemic therapies in AA. The categories with the least consensus were phototherapy and nonprescription therapies.

Limitations

The study included a comprehensive list of systemic treatments for AA but not all treatments used.

Conclusion

Despite divergent opinions among experts, consensus was achieved on a number of pertinent questions. The concluding statement also highlights areas where expert consensus is lacking and where an international patient registry could enable further research.

Le texte complet de cet article est disponible en PDF.

Abbreviations used : AA, ACE, IL, ILC, JAK, RCT, SALT


Plan


 Drs Meah and Wall are cofirst authors.


© 2020  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 83 - N° 1

P. 123-130 - juillet 2020 Retour au numéro
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