Treatment of recalcitrant adult alopecia areata universalis with oral azathioprine

Vañó‐Galván, Sergio; Hermosa-Gelbard, Ángela; Sánchez-Neila, Natalia; Miguel‐Gomez, Laura; Saceda‐Corralo, David; Rodrigues‐Barata, Rita; Jaén, Pedro

doi:10.1016/j.jaad.2015.12.055

Cited by 27 publications

(27 citation statements)

References 5 publications

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“…Previous studies described the efficacy of MTX, alone or in combination with corticosteroids, for the treatment of extensive forms of AA with successful response in both adult and paediatric populations. [4][5][6] Other studies tested AZA alone 7,8 in the treatment of AA, with clinical outcomes and follow-up almost comparable to our experience. The association AZA plus MTX has never been experienced before in the treatment of severe forms of AA; however, the therapeutic concept has already been described by our group in adult patients with severe atopic dermatitis.…”

Section: Editorsupporting

confidence: 71%

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Azathioprine in combination with methotrexate: a therapeutic alternative in severe and recalcitrant forms of alopecia areata?

Mascia

Milpied

Darrigade

et al. 2019

Acad Dermatol Venereol

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Section: Editorsupporting

confidence: 71%

“…This innovative and low-cost approach could be considered in the therapeutic arsenal against refractory forms of AA, in the context of the clinical development of JAK1 and JAK2 inhibitors in the treatment of severe AA. [3][4][5][6][7][8][9][10]…”

Section: Editormentioning

confidence: 99%

Azathioprine in combination with methotrexate: a therapeutic alternative in severe and recalcitrant forms of alopecia areata?

Mascia

Milpied

Darrigade

et al. 2019

Acad Dermatol Venereol

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“…Additionally, 66% showed no signs of relapse after treatment discontinuation; the remaining patients relapsed after 2.5 months. 100,101 Although research on this treatment is scarce, this is another systemic therapy that can be considered for recalcitrant AA. However, the risk of systemic side-effects should be considered.…”

Section: Azathioprinementioning

confidence: 99%

Management of alopecia areata: Updates and algorithmic approach

Lee

2017

The Journal of Dermatology

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Alopecia areata is a chronic, recurrent and non-scarring alopecia. The prognoses of patients are very diverse. The larger the area of hair loss, the poorer the treatment response and greater the probability of chronic disease progression. Numerous treatments have been introduced, but curative treatments have yet to be established. The long-term efficacy of the current treatments is minimal, and the therapeutic response varies widely. Recent clinical trials have attempted to apply therapeutic metrics, such as the Severity of Alopecia Tool, and many have been designed as randomized controlled studies, enabling a more precise evaluation of existing treatments. There have been updates in practice, efficacy or indications of therapeutics that have been previously used. Moreover, the use of novel treatments such as biologics has recently been introduced. Commonly, the most important factor in determining the treatment modality for alopecia areata has been the extent of hair loss. However, if the disease activity is high and likely to progress, combination therapy with adjuvant modalities will be more desirable. This review will discuss the therapeutic effects of existing and newly-introduced treatments based on their quantity, quality of evidence and expected complications. In addition, an algorithmic approach to management of alopecia areata is proposed according to clinical subtype, severity, onset and activity of the disease.

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“…Data from a larger multicentre observational review of treatments for alopecia in Spain identified 15 of 132 patients who were treated with MTX; five in combination with prednisolone and 10 with MTX monotherapy. 27 Three on combination therapy responded, and none of those on MTX alone, although six were reported as partial responders (< 75% regrowth).…”

Section: Mtx Plus Prednisolonementioning

confidence: 91%

Is methotrexate an effective and safe treatment for maintaining hair regrowth in people with alopecia totalis? A Critically Appraised Topic

2018

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We found insufficient evidence to conclude whether MTX is useful for maintaining regrowth in extensive AA. We found some evidence to suggest that hair regrowth may be induced by MTX when used in combination with systemic corticosteroids, but it was difficult to attribute responses to any one treatment or spontaneous regrowth. Included case series were at a high risk of bias. Randomized controlled trials are needed to evaluate whether MTX alone, or in combination with corticosteroids, vs. placebo is useful for inducing and/or maintaining remission of hair regrowth. In the meantime, MTX may occasionally be considered in people with severe disease that significantly impacts on their quality of life.

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Treatment of recalcitrant adult alopecia areata universalis with oral azathioprine

Cited by 27 publications

References 5 publications

Azathioprine in combination with methotrexate: a therapeutic alternative in severe and recalcitrant forms of alopecia areata?

Azathioprine in combination with methotrexate: a therapeutic alternative in severe and recalcitrant forms of alopecia areata?

Management of alopecia areata: Updates and algorithmic approach

Is methotrexate an effective and safe treatment for maintaining hair regrowth in people with alopecia totalis? A Critically Appraised Topic

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