Efficacy of Oral Apremilast in The Treatment of Alopecia Areata, at The Tertiary Care Hospital, Karachi

Abstract

Background: Alopecia Areata (AA) presents a significant challenge in dermatology due to its unpredictable nature and psychological impact. Recent studies have focused on oral Apremilast, a phosphodiesterase 4 inhibitor, for its potential efficacy in treating AA. Objective: This study aims to assess the efficacy of oral Apremilast in treating alopecia areata at a tertiary care hospital in Karachi. Methods: A randomized controlled trial was conducted in the Department of Dermatology at Jinnah Postgraduate Medical Centre, Karachi, from August 2022 to June 2023. The study enrolled 85 patients exhibiting various symptoms of AA. Apremilast was administered orally at 30 mg twice daily, following a 5-day initial titration dose. The Severity of Alopecia Tool (SALT score) was employed to measure treatment effectiveness at the outset, 6 weeks, and 12 weeks. Data analysis was executed using SPSS version 23. Results: Participants had an average age of 28.34 years (SD = 4.20), with a gender distribution of 51 women (60.0%) and 34 men (40.0%). The study demonstrated a significant decrease in SALT Scores from 62.42 ± 5.17 to 41.53 ± 13.44 at Week 12 (mean difference: 20.89, 95% CI: 17.86 to 23.92, p-value: 0.0001), indicating a notable reduction in AA severity. Oral apremilast was found to be effective in treating AA in 80.0% of patients. Conclusion: The study concludes that oral Apremilast significantly reduces the severity of alopecia areata, as evidenced by the decline in SALT Scores from baseline to Week 12. These findings suggest that oral Apremilast may serve as a viable alternative treatment for AA, deserving further clinical exploration.