Introduction: Alopecia areata (AA) is a chronic, immune-mediated inflammatory disorder characterized by nonscarring hair loss. The management of AA poses challenges due to its unpredictable course and variable response to treatment. In this comparative study, we evaluated the efficacy and safety of oral apremilast, intralesional corticosteroids (ILC) and a combination of both in patients with patchy AA.

Methods: Sixty patients with patchy AA were randomly assigned to three treatment groups: oral apremilast (Group A), ILC (Group B), and a combination of both (Group C). The Severity of Alopecia Tool (SALT) score was used to assess the extent of hair loss before treatment, after 3 months, and at 6 months of follow-up. Adverse events and complications were also monitored. The changes in SALT score from baseline between the three groups were assessed by using non-parametric statistical tests. The statistical significance was judged at 5% level of significance.

Results: Findings demonstrated significant higher reduction in median SALT scores after treatment i.e., 2.47 (1.76, 5.07), p < 0.001 as well as after six months follow up 5.08 (3.80, 7.53), p < 0.001 in patients treated with ILC compared to other two groups. Neither apremilast monotherapy nor its combination with ILC demonstrated statistically significant improvement, although individual responses were observed. Complications were minimal, with transient pain and burning sensation reported during ILC injections and a few cases of gastritis and relapse in the oral apremilast group.

Conclusion: These findings suggest that ILC remains an effective treatment option for patchy AA. This study did not demonstrate statistically significant efficacy of oral apremilast, either as monotherapy or in combination with ILC, though larger studies may be needed to evaluate potential benefits in specific patient subgroups. Further research with larger sample sizes and longer-term follow-up is needed to validate these findings and optimize treatment approaches for AA.

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00403-024-03642-5DOI Listing

Publication Analysis

Top Keywords

oral apremilast
12
patients patchy
12
apremilast intralesional
8
intralesional corticosteroids
8
combination patients
8
alopecia areata
8
hair loss
8
salt score
8
comparing efficacy
4
efficacy oral
4

Similar Publications

Introduction: Alopecia areata (AA) is a chronic, immune-mediated inflammatory disorder characterized by nonscarring hair loss. The management of AA poses challenges due to its unpredictable course and variable response to treatment. In this comparative study, we evaluated the efficacy and safety of oral apremilast, intralesional corticosteroids (ILC) and a combination of both in patients with patchy AA.

View Article and Find Full Text PDF

This study systematically reviews existing data on the efficacy of Tyrosine Kinase 2 (TYK2) inhibitors in comparison to placebo or standard treatments for therapeutic benefit and improving quality of life in dermatological diseases. Seventeen records representing 13 clinical trials, one matching-adjusted indirect comparison, and one case study were included. Results indicate that Deucravacitinib is superior to placebo, Apremilast and Adalimumab in treating adult patients with moderate-to-severe plaque psoriasis and superior to placebo in the treatment of adults with systemic lupus erythematosus.

View Article and Find Full Text PDF

Chemical, Biochemical, and Structural Similarities and Differences of Dermatological cAMP Phosphodiesterase-IV Inhibitors.

J Invest Dermatol

November 2024

Department of Molecular Biophysics and Biochemistry, Yale University, New Haven, Connecticut, USA; Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA; Program in Translational Biomedicine, Yale School of Medicine, New Haven, Connecticut, USA. Electronic address:

Article Synopsis
  • - Roflumilast is the third PDE4 inhibitor used in dermatology for topical treatments of conditions like psoriasis and dermatitis, while earlier drugs like apremilast and crisaborole target oral and topical usage differently.
  • - It is the most effective among the three inhibitors, showcasing a significantly lower IC value of 0.7 nM, compared to apremilast (0.14 μM) and crisaborole (0.24 μM), suggesting much greater potency.
  • - The study highlights how PDE4 inhibitors improve anti-inflammatory responses by prolonging cAMP signals within immune cells, and discusses potential chemical modifications to enhance their effectiveness based on newly identified invariant residues and metal ion interactions in their catalytic domains
View Article and Find Full Text PDF

Importance: Safe and effective long-term treatments for moderate to severe plaque psoriasis are needed.

Objective: To evaluate the long-term safety and efficacy of deucravacitinib through 3 years (week 148) in the randomized POETYK PSO-1, PSO-2, and nonrandomized long-term extension (LTE) trials.

Design, Setting, And Participants: PSO-1/PSO-2 were global, 52-week, randomized, double-blinded phase 3 trials in patients with moderate to severe plaque psoriasis.

View Article and Find Full Text PDF

Apremilast: First Pediatric Approval.

Paediatr Drugs

November 2024

Springer Nature, Private Bag 65901, Mairangi Bay, Auckland, 0754, New Zealand.

Article Synopsis
View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!