Pulse Corticosteroid Therapy for Alopecia Areata: Long-Term Outcome after 10 Years

Abstract

Background: Few data are available concerning the efficiency of pulse corticosteroids in alopecia areata (AA). Objective: Our purpose was to assess the long-term outcomes of patients treated with methylprednisolone bolus. Methods: This study included 60 patients treated between 1995 and 2000. The short-term outcomes were analyzed in 2000. The long-term assessment of 30 patients was performed in 2010 by phone questionnaire. Results: Significant hair regrowth was observed in 10/30 patients at 6 months after the bolus treatment. Half of the plurifocalis AA patients were responders at 6 months, but less than one quarter of alopecia totalis (AT) and alopecia universalis (AU) patients responded. Long-term outcomes were assessed after a mean duration of 12.3 years; 8/10 initial responders had mild or no disease, and 14/20 initial nonresponders had severe AA. Conclusions: This study confirmed the low efficiency, both short- and long-term, of this treatment for AT and AU.

Long-Term Prognosis of Alopecia Totalis and Alopecia Universalis: A Longitudinal Study with More than 10 Years of Follow-Up: Better than Reported

“…First, current hair loss status was evaluated by chart review and phone survey as in previous studies on AA long-term prognosis [10,17] . Second, limited numbers of patients were included.…”

Intravenous methylprednisolone pulse therapy in severe alopecia areata

“…In another study, a low efficiency of methylprednisolone bolus for alopecia totalis and universalis was noted at 6 months and after a mean of 12.3 years follow up. [23] Relapse and lack of hair regrowth after topical treatments represent a reason for the clinician to continue the search for additional therapeutic options. Even though no significant side effects of methylprednisolone pulse therapy in alopecia areata have yet been reported, one must always be cautious, monitor patients carefully and expect a positive benefit/risk ratio.…”

Current and future pharmacotherapy for alopecia areata

“…Pulse therapy is more effective on recent onset alopecia (< 6 months) than chronic or recalcitrant alopecia [59]. Minoxidil has been suggested to delay relapses after steroid interruption ( Table 1) [40,[60][61][62][63][64][65][66][67][68][69][70].…”