[4 min read] Immunotherapy for alopecia

At what rate is contact immunotherapy associated with satisfactory hair regrowth in patients with alopecia areata?

Contact immunotherapy with diphenylcyclopropenone or squaric acid dibutyl ester is a preferred treatment for severe alopecia areata; however, the defined criteria for therapeutic hair regrowth and regrowth rate have been highly heterogeneous across studies. An analysis aimed to summarise the clinical outcomes of contact immunotherapy for alopecia areata according to standardised criteria for therapeutic hair regrowth and several prognostic factors.

Included were clinical trials or observational studies that investigated contact immunotherapy for alopecia areata and sub-grouped the disease into patchy alopecia or alopecia totalis/universalis and reported their hair regrowth rates. Studies that investigated combination therapy or non-conventional protocol were excluded.

In the meta-analysis of 45 studies that included 2,227 patients, any hair regrowth was observed in 74.6%, minor regrowth in 64.9%, major regrowth in 56.1%, and complete regrowth in 42.6% of patients with patchy alopecia. Any regrowth was observed in 54.5%, minor regrowth in 45.0%, major regrowth in 28.7%, and complete regrowth in 24.9% of patients with alopecia totalis/universalis.

Various factors were associated with the clinical outcomes of contact immunotherapy for alopecia areata, with significant differences in hair regrowth rates according to the level of expected therapeutic regrowth. Researchers suggested that quantitative summarisation may improve patient education and lead to better therapeutic adherence and outcomes.

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Source: Lee S, Kim BJ, Lee YB, Lee W. Hair Regrowth Outcomes of Contact Immunotherapy for Patients With Alopecia AreataA Systematic Review and Meta-analysisJAMA Dermatol. 2018;154(10):1145–1151. doi:10.1001/jamadermatol.2018.2312

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