Alopecia areata totalis and universalis: a multicenter review of 132 patients in Spain

Vañó‐Galván, Sergio; Fernández‐Crehuet, Pablo; Grimalt, Ramón; García-Hernández, M.J.; Rodrigues‐Barata, Rita; Arias‐Santiago, Salvador; Molina-Ruiz, Ana María; García‐Lora, E.; Domínguez-Cruz, J.J.; Brugués, Albert; Ferrando, Juan; Serrano-Falcón, C.; Serrano, Salvio; Paoli, John; Camacho, Francisco

doi:10.1111/jdv.13959

Cited by 23 publications

(30 citation statements)

References 44 publications

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“…Age of onset of AT/AU was not associated with prognosis. Of note, seven AT/AU patients (5.3%) had spontaneous recovery and five (3.8%) had persistent regrowth after a minimum of 12 months and a median follow‐up time of 14 months …”

Section: Resultsmentioning

confidence: 99%

“…No gold standard treatment regimen exists in the absence of randomized control trials. Initial recovery rates are often higher than long‐term recovery rates due to the high prevalence of relapse . Jang et al .…”

Section: Discussionmentioning

confidence: 99%

“…(2012) and Vaño‐Galvan et al . (2016) showed favourable results although they did not use complete recovery as an end point …”

Section: Discussionmentioning

confidence: 99%

“…Vañó‐Galván et al . noted that 14% of their patients responded to treatment on the second attempt of the same treatment . In addition, attempting therapy may be useful for patients’ mental health as one study noted that despite a long‐term response rate of only about 13%, 96% of patients were happy they attempted psoralen UVA therapy for their AT/AU because they were glad they attempted to treat their disease .…”

Section: Discussionmentioning

confidence: 99%

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Alopecia totalis and universalis long‐term outcomes: a review

Burroway

Griggs

Tosti

2019

Acad Dermatol Venereol

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Alopecia totalis (AT) and universalis (AU) represent the most severe subtypes of alopecia areata with more dramatic features and worse prognosis. The goal of this review is to identify all studies with long‐term prognostic data on patients with AT and AU and provide a long‐term outcome estimate. The PubMed database was queried to identify all articles discussing the long‐term prognosis of AT and AU. A total of nine articles discussing long‐term recovery rates of AT and AU were identified. The articles described 689 (162 = AT, 245 = AU, 282 = not specified) total patients. Six of the nine studies identified complete recovery as a potential end point in a total of 375 (39 = AT, 75 = AU, 261 = not specified) patients. According to these studies 8.5% (32/375) of AT and AU patients achieved complete recovery. A larger proportion of patients will obtain at least transient recovery periods of partial or total hair regrowth. The poor long‐term outcomes of AT and AU may cause patients to lose hope with treatment. Response to treatment is often unpredictable, and physicians should be aware of the prognosis and its effects in order to properly counsel patients.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…(2012) and Vaño‐Galvan et al . (2016) showed favourable results although they did not use complete recovery as an end point …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Alopecia totalis and universalis long‐term outcomes: a review

Burroway

Griggs

Tosti

2019

Acad Dermatol Venereol

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“…More recent studies, performed by Kumar et al, demonstrated a low incidence of DLE in patients with AA, with only one of 104 patients affected. Furthermore, in the study of Vaño‐Galvan, et al . reviewing 132 patients diagnosed with either alopecia areata totalis or universalis, no case with associated DLE was found.…”

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confidence: 96%

When trichoscopy enlightens clinics: more about discoid lupus

et al. 2018

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Characterization of scalp, eyelash and eyebrow hair regrowth in patients with severe alopecia areata randomized to placebo in brave AA1 and brave AA2 trials

Zlotogorski,

Vañó‐Galván,

Piraccini

et al. 2024

JEADV Clinical Practice

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BackgroundAlopecia areata (AA) is an auto‐immune disorder characterized by non‐scarring hair loss. With the emergence of effective therapies for severe AA, there is a need to better understand the prognosis of untreated AA, specifically the potential for spontaneous hair regrowth.ObjectivesTo describe hair regrowth occurring on placebo during the first 36 weeks of the BRAVE‐AA trials.MethodsThis analysis pools the data of 345 placebo‐treated patients from BRAVE‐AA1 and BRAVE‐AA2, two Phase 3 clinical trials of baricitinib, an oral selective Janus kinase inhibitor, approved for the treatment of adults with severe AA. Scalp hair regrowth was assessed by the mean change from baseline in Severity of Alopecia Tool (SALT), the proportion of patients achieving a SALT score ≤20 (less than 20% hair loss); and SALT50 (50% improvement from baseline in SALT score), between Weeks 0 and 36. Patients achieving Clinician Reported Outcome (ClinRO) measures for eyebrow and eyelash hair loss™ scores of 0 or 1 (full coverage or minimal gaps) with a ≥2‐point improvement from baseline were also assessed.ResultsAt Week 36, the mean [SD] change from baseline in SALT score was −5.5 [20.9], with 14 (4.1%) and 32 (9.3%) of the 345 placebo‐treated patients achieving a SALT score ≤20 and SALT50, respectively. A total of 9 (3.8%) and 8 (4.3%) patients achieved a ClinRO score of 0 or 1 with a ≥2‐point improvement from baseline for eyebrow (n = 236) and eyelash (n = 186), respectively. Patients achieving a SALT score ≤20 tended to have a lower mean SALT score at baseline and a shorter duration since the onset of AA.ConclusionsThe low likelihood of spontaneous hair regrowth observed in the BRAVE‐AA trials is consistent with other published literature. These results can aid in understanding the prognosis of severe AA when left untreated and, in turn, inform treatment‐related decisions.

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Alopecia areata totalis and universalis: a multicenter review of 132 patients in Spain

Abstract: Treatment of AAT and AAU is challenging. Although an initial regrowth may be achieved, the duration of response is usually short. There were no significant differences on the effectiveness or duration of response between the various systemic therapies.

Cited by 23 publications

References 44 publications

Alopecia totalis and universalis long‐term outcomes: a review

Alopecia totalis and universalis long‐term outcomes: a review

When trichoscopy enlightens clinics: more about discoid lupus

Characterization of scalp, eyelash and eyebrow hair regrowth in patients with severe alopecia areata randomized to placebo in brave AA1 and brave AA2 trials

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