Alopecia Areata and Dexamethasone Mini-Pulse Therapy, A Prospective Cohort: Real World Evidence and Factors Related to Successful Response

Sánchez‐Díaz, Manuel; Montero‐Vílchez, Trinidad; Bueno-Rodriguez, Ahinoa; Molina-Leyva, Alejandro; Arias‐Santiago, Salvador

doi:10.3390/jcm11061694

Cited by 10 publications

(9 citation statements)

References 34 publications

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“…Oral dexamethasone pulse was relatively ineffective in patients with hypothyroidism and those aged under 15 years. No greater reduction in the Severity of Alopecia Tool (SALT) score was reported in combination therapy of dexamethasone pulse and oral minoxidil (25). Another study by Sharma et al on 30 patients with widespread and diffuse AA who received oral dexamethasone showed promising results, as more than 60% of patients had completed or over 75% hair growth during five months.…”

Section: Oral Mini-pulse Of Dexamethasonementioning

confidence: 99%

Efficacy and Adverse Effects of Corticosteroid Pulse Therapy in Alopecia Areata

Rastaghi,

Kaveh,

Yazdanpanah

et al. 2023

Dermatol Pract Concept

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Introduction: Alopecia areata (AA) is a non-scarring, autoimmune hair loss disorder, varying in severity from small round hairless patches to the total loss of scalp or body hair. Steroid pulse therapy outcomes for AA vary. Objective: This study aimed to review the related literature regarding the efficacy, relapse rates, side effects, and prognostic factors associated with the response to different pulse corticosteroid treatments. Methods: The terms "pulse steroid therapy AND alopecia areata" and "pulse corticosteroid therapy AND alopecia areata" were searched on PubMed and Google Scholar. Results: A total of 24 articles were assessed. There was no difference in outcomes and side effects between intravenous and oral pulse corticosteroid therapy. The relapse rate and efficacy depended on the time of AA onset, age, and type: improved outcomes and decreased relapse were linked with recent onset (<6 months), younger age (<10 years), and the multifocal type. Patients with a past medical history of atopy, nail pitting, or thyroid disease and those with severe forms of AA, like alopecia totalis and alopecia universalis, had the least improvement. Conclusion: Pulse corticosteroids effectively induce hair regrowth in AA. Betamethasone seems to be the most effective agent (followed by intramuscular triamcinolone), especially in severe cases, but more side effects may accompany it. Combining this agent with other medications can reduce the dosage and side effects. Pulses of prednisolone and methylprednisolone are less effective but safer, as they have low relapse rates and adverse effects. A combination of them with other drugs can increase their efficacy.

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Section: Oral Mini-pulse Of Dexamethasonementioning

confidence: 99%

Efficacy and Adverse Effects of Corticosteroid Pulse Therapy in Alopecia Areata

Rastaghi,

Kaveh,

Yazdanpanah

et al. 2023

Dermatol Pract Concept

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“…We compared our series of patients with two other reported series in which patients received the same dosage of 0.1 mg/kg/day of dexamethasone twice weekly (Table 2). 1,10 Our data showed a higher mean age, family history, duration of AA and eyebrow and eyelash involvement. We first reported the weight of AA patients undergoing MPCT‐OD which we considered that is an important data due to the adjustment of dexamethasone dosage.…”

Section: N = 45mentioning

confidence: 99%

Mini pulse corticosteroid therapy with oral dexamethasone for moderate to severe alopecia areata: A multicentric study

Lobato‐Berezo

March-Rodríguez

Grimalt

et al. 2022

Dermatologic Therapy

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Extensive subtypes of alopecia areata (AA) (totalis, universalis, or multifocal) still have no approved and effective treatments in Europe, although Janus kinase inhibitors, such as baricitinib, are promising treatments that have been recently approved by the FDA. Nowadays, the higher costs and the lower experience with Janus kinase inhibitors, provide more difficulties in its accessibility. On the other hand, different corticosteroids regimens have been evaluated with conflicting results from decades. In 2016, a new regimen of mini pulse corticosteroid therapy with oral dexamethasone (MPCT-OD) 0.1mg/kg/day twice per week for adult patients with alopecia areata totalis or universalis, was reported to be effective with a lower rate of adverse effects. We performed a retrospective and multicentric study to collect data from patients with extensive forms of alopecia areata who had received MPCTOD (0.1 mg/kg/day twice weekly of dexamethasone) for at least 24 weeks. We included adult patients (≥18 years) with extensive forms of AA (SALT index ≥ 10) that did not respond to previous treatments. Variables including epidemiological and clinical data were recorded. Therapeutic response was assessed through the % change in SALT score (from 0 to 100%) and the changes in eyebrow and eyelash alopecia index (EBA, ELA) from baseline to 24 weeks after the beginning of the treatment. Dexamethasone dosage, duration of the treatment, time until response, time to relapse, adverse effects, and discontinuation were also recorded.

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“…It is an oral inhibitor of JAK 1 and 2 that can interrupt the signaling of cytokines involved in the pathogenesis of alopecia areata [ 19 ]. Moreover, mini-pulse therapy with oral corticosteroids could be safer in maintaining efficacy in cases of severe alopecia areata [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

How Our Microbiome Influences the Pathogenesis of Alopecia Areata

Sánchez-Pellicer

Navarro-Moratalla²,

Núñez‐Delegido³

et al. 2022

Genes

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Alopecia areata is a multifactorial autoimmune-based disease with a complex pathogenesis. As in all autoimmune diseases, genetic predisposition is key. The collapse of the immune privilege of the hair follicle leading to scalp loss is a major pathogenic event in alopecia areata. The microbiota considered a bacterial ecosystem located in a specific area of the human body could somehow influence the pathogenesis of alopecia areata, as it occurs in other autoimmune diseases. Moreover, the Next Generation Sequencing of the 16S rRNA bacterial gene and the metagenomic methodology have provided an excellent characterization of the microbiota. The aim of this narrative review is to examine the published literature on the cutaneous and intestinal microbiota in alopecia areata to be able to establish a pathogenic link. In this review, we summarize the influence of the microbiota on the development of alopecia areata. We first introduce the general pathogenic mechanisms that cause alopecia areata to understand the influence that the microbiota may exert and then we summarize the studies that have been carried out on what type of gut and skin microbiota is found in patients with this disease.

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Alopecia Areata and Dexamethasone Mini-Pulse Therapy, A Prospective Cohort: Real World Evidence and Factors Related to Successful Response

Cited by 10 publications

References 34 publications

Efficacy and Adverse Effects of Corticosteroid Pulse Therapy in Alopecia Areata

Efficacy and Adverse Effects of Corticosteroid Pulse Therapy in Alopecia Areata

Mini pulse corticosteroid therapy with oral dexamethasone for moderate to severe alopecia areata: A multicentric study

How Our Microbiome Influences the Pathogenesis of Alopecia Areata

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