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Alopecia areata is a chronic, immune-driven ailment marked by nonscarring hair loss, often presenting a therapeutic challenge due to its unpredictable course and variable treatment outcomes.
Intralesional corticosteroids markedly reduce hair loss in patchy alopecia areata, while apremilast, alone or with corticosteroids, shows no clear benefit.
Alopecia areata is a chronic, immune-driven ailment marked by nonscarring hair loss, often presenting a therapeutic challenge due to its unpredictable course and variable treatment outcomes. This study examined the safety and effectiveness of three approaches—oral apremilast, intralesional corticosteroids (ILC), and their combination—in addressing patchy alopecia areata.
Overall, 60 individuals suffering from patchy alopecia areata were randomly allocated to one of three treatment arms: oral apremilast (Group A), ILC (Group B), or a combination of both (Group C). Hair loss severity was quantified via the Severity of Alopecia Tool (SALT) score at baseline, 3 months, and 6 months. Safety and adverse events were closely monitored. Group comparisons were carried out using non-parametric statistical tests, with significance set at p < 0.05.
ILC therapy resulted in a markedly greater reduction in median SALT scores—2.47 (1.76, 5.07) post-treatment, and 5.08 (3.80, 7.53) at 6 months—as opposed to the other groups. In contrast, neither apremilast alone nor its combination with ILC illustrated statistically significant improvements, though some individual responses were observed. Reported side effects were mild, with transient pain and burning at ILC injection sites, along with occasional cases of gastritis and relapse in the apremilast group.
ILC proved to be a front-runner for patchy alopecia areata management. Apremilast, whether as monotherapy or in combination, did not achieve statistical significance in this study, though its role in specific patient subsets warrants further exploration. Larger trials with extended follow-ups are essential to refine therapeutic strategies and optimize outcomes for such patients.
Archives of Dermatological Research
Comparing the efficacy of oral apremilast, intralesional corticosteroids, and their combination in patients with patchy alopecia areata: a randomized clinical controlled trial
Sankalp Awasthi et al.
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