Treating Alopecia Areata: Future Treatments

Noticed some patchy hair loss randomly across your scalp? Maybe even a large portion of your hair has disappeared for no apparent reason. Has this happened before? Did it regrow spontaneously? Frustrated about the lack of treatment options? These are the symptoms of alopecia areata, a condition where the immune system begins attacking hair follicles1,2. It can affect a diverse range of people including different ages as well as both men and women. Doctors are equipped with an arsenal of treatments to recommend which are successful for some, but unfortunately not everyone, especially more severe cases3. Even worse, once hair has regrown and a patient has recovered, it’s not uncommon to experience a relapse or recurrence. To improve this prognosis, researchers have been investigating some new therapy options. Listed below are some novel ideas which may turn into the newest options for alopecia areata treatment.

Abatacept

Abatacept is an immune modulator that is currently in use for rheumatoid arthritis therapy. It is believed to work by limiting the amount of inflammation4. A phase II clinical trial is in progress which means there should be more information soon, as early as this July5.

Low-dose interleukin-2

Interleukin-2 is a protein in the body whose job is to send messages to the immune system. The hope is that in alopecia areata patients, interleukin-2 will be able to signal to the immune system to back down. It was successful in inducing partial hair regrowth in 4 out of 5 people in a clinical trial6.

Simvastatin and ezetimibe

A combination of simvastatin and ezetimibe is thought to protect immune privilege in the hair follicle7. Immune privilege is a term used to describe a natural phenomenon whereby the immune system recognizes not to attack. There are reports of simvastatin/ezetimibe successfully treating some severe cases of hair loss8,9  while in a study of 19 people the majority experienced regrowth of about 20%10.

Overall, even though there is currently no one cure that works for everyone suffering from alopecia areata, new research is promising. With the investigation of new immune-targeting medication, there is hope for better treatment options in the near future.

Article by: Dr. J.L. Carviel, PhD, Mediprobe Research Inc.

References

  1. Gilhar A, Kalish RS. Alopecia areata: a tissue specific autoimmune disease of the hair follicle. Autoimmun Rev. 2006 Jan;5(1):64–9.
  2. McElwee K, Freyschmidt-Paul P, Ziegler A, Happle R, Hoffmann R. Genetic susceptibility and severity of alopecia areata in human and animal models. Eur J Dermatol EJD. 2001 Feb;11(1):11–6.
  3. Delamere FM, Sladden MM, Dobbins HM, Leonardi-Bee J. Interventions for alopecia areata. Cochrane Database Syst Rev. 2008;(2):CD004413.
  4. Moreland L, Bate G, Kirkpatrick P. Abatacept. Nat Rev Drug Discov. 2006 Mar;5(3):185–6.
  5. Mackay-Wiggan J. An Open-Label Single-Arm Clinical Trial to Evaluate The Efficacy of Abatacept in Moderate to Severe Patch Type Alopecia Areata [Internet]. 2013 [cited 2016 Feb 25]. Available from: https://clinicaltrials.gov/ct2/show/NCT02018042?term=NCT02018042&rank=1
  6. Castela E, Le Duff F, Butori C, Ticchioni M, Hofman P, Bahadoran P, et al. Effects of low-dose recombinant interleukin 2 to promote T-regulatory cells in alopecia areata. JAMA Dermatol. 2014 Jul;150(7):748–51.
  7. Namazi MR. Statins: novel additions to the dermatologic arsenal? Exp Dermatol. 2004 Jun;13(6):337–9.
  8. Ali A, Martin JM. Hair growth in patients alopecia areata totalis after treatment with simvastatin and ezetimibe. J Drugs Dermatol JDD. 2010 Jan;9(1):62–4.
  9. Robins DN. Case reports: alopecia universalis: hair growth following initiation of simvastatin and ezetimibe therapy. J Drugs Dermatol JDD. 2007 Sep;6(9):946–7.
  10. Lattouf C, Jimenez JJ, Tosti A, Miteva M, Wikramanayake TC, Kittles C, et al. Treatment of alopecia areata with simvastatin/ezetimibe. J Am Acad Dermatol. 2015 Feb;72(2):359–61.