Last update 01 Nov 2024

Alopecia totalis

Last update 01 Nov 2024

Basic Info

Synonyms

ALOPECIA TOTALIS, Alopecia (capitis) totalis, Alopecia totalis

+ [14]

Introduction

A form of alopecia areata, an inflammatory disease of the hair follicle, characterized by a complete loss of hair of the entire scalp which becomes glabrous.

Drugs associated with Alopecia totalis

Efalizumab

Target

CD11a

Mechanism

CD11a antagonists

Active Org.

Merck KGaA

Originator Org.

Genentech, Inc.

Active Indication

Psoriasis

Inactive Indication

Age Related Macular Degeneration [+11]

Drug Highest PhaseApproved

First Approval Ctry. / Loc.

First Approval Date27 Oct 2003

BNZ-1

Target

IL-15 x IL-2 x IL-9

Mechanism

IL-15 inhibitors [+2]

Active Org.

Equillium, Inc. [+1]

Originator Org.

Bioniz Therapeutics, Inc.

Active Indication

Alopecia Areata [+3]

Inactive Indication

Adult T-Cell Leukemia-Lymphoma [+6]

Drug Highest PhasePhase 2

First Approval Ctry. / Loc.-

First Approval Date20 Jan 1800

ATI-502

Target

JAK1 x JAK3

Mechanism

JAK1 inhibitors [+1]

Active Org.-

Originator Org.

Rigel Pharmaceuticals, Inc.

Active Indication-

Inactive Indication

Alopecia Areata [+5]

Drug Highest PhaseDiscontinued

First Approval Ctry. / Loc.-

First Approval Date20 Jan 1800

Clinical Trials associated with Alopecia totalis

NCT06283316 / RecruitingNot ApplicableIIT

Systemic Treatments for Alopecia Areata Registry

A multicenter prospective registry (STA2R) is conducted to assess systemic treatments for alopecia areata, focusing on effectiveness, safety, and long-term outcomes.

Start Date17 Jan 2024

Sponsor / Collaborator-

NCT06278402 / CompletedPhase 3IIT

Efficacy of Oral Tofacitinib in Moderate to Severe Alopecia Areata, Totalis and Universalis at Tertiary Care Hospital, Karachi.

To determine the efficacy of oral Tofacitinib in the treatment of moderate to severe alopecia areata, totalis and universalis at tertiary care hospital of Karachi, Pakistan. Efficacy of treatment in patients presenting with alopecia areata will be assessed using SALT Score on follow up at 6,12 and 24 weeks where four categories of treatment response were defined: 0 (re-growth ≤10%), 1 (11-25%), 2 (26-50%), 3 (51-75%) and 4 (re-growth >75%). Efficacy will be considered if re-growth ≥ 2.

Start Date01 Jul 2023

Sponsor / Collaborator

Jinnah Hospital Lahore

NCT05589610 / CompletedPhase 2

An Open-label, Phase 2 Study to Assess the Safety and Efficacy of EQ101 in Adult Subjects With Moderate to Severe Alopecia Areata

The purpose of this study is to assess the safety, PK, and PD of EQ101 as well as measure the efficacy of EQ101 at Week 24 compared to Baseline in adult subjects with moderate to severe AA. The study consists of 3 phases: a screening phase of up to 5 weeks, a treatment phase of 24 weeks, and a follow-up phase of 4 weeks. Study drug will be administered via intravenous (IV) push weekly.

Start Date19 Dec 2022

Sponsor / Collaborator

Equillium, Inc.

[+1]

100 Clinical Results associated with Alopecia totalis

100 Translational Medicine associated with Alopecia totalis

0 Patents (Medical) associated with Alopecia totalis

521

Literatures (Medical) associated with Alopecia totalis

18 Sep 2024·Clinical and Experimental Dermatology

Efficacy and safety of topical corticosteroid treatment under occlusion for severe alopecia areata in children: a single-centre retrospective analysis

Article

Author: Jung, Kyung Eun ; Seo, Young-Joon ; Lim, Han Hyuk ; Jin, Soyoung ; Hong, Dong-Kyun ; Lee, Tae Kwan ; Kim, Yoo-Mi ; Lee, Young Yoon ; Son, Seungjin ; Shin, Jung-Min ; Lee, Young

AbstractBackgroundAlopecia areata (AA) has a poor clinical course in children. There are no reliable therapeutic options for children with severe AA, including alopecia totalis (AT) and alopecia universalis (AU).ObjectivesWe evaluated the efficacy and adverse effects of a potent topical corticosteroid (TCS) under occlusion in paediatric patients with severe AA.MethodsWe reviewed records of 23 patients under the age of 10 years with AT or AU treated with a potent TCS (0.05% clobetasol propionate or 0.3% diflucortolone valerate) for 8 h under occlusion with a plastic film. We used the Severity of Alopecia Tool (SALT) to measure clinical improvement. The primary endpoint was a SALT score of ≤ 20 at 6 months. We analysed the change in cortisol levels to identify the long-term safety of TCS therapy on the hypothalamus–pituitary–adrenal axis.ResultsNineteen of the 23 patients (83%) reached SALT ≤ 20 at 6 months. Six patients relapsed over the 6-month follow-up period. Four patients were suspected of having adrenal insufficiency. However, the cortisol levels of the patients recovered to normal within 1 month of lowering the TCS potency or changing to nonsteroidal treatments. Limitations include the retrospective design and small sample size.ConclusionsThis study shows that a potent TCS occlusion may be a safe treatment option in paediatric patients with severe AA. Further long-term studies are required to evaluate the safety and recurrence of TCS occlusion therapy for paediatric AA.

01 Sep 2024·Journal of Cutaneous Medicine and Surgery

Tofacitinib in Pediatric Alopecia Areata Totalis and Alopecia Universalis: A Retrospective Analysis From India

Article

Author: Behera, Biswanath ; Thakur, Vishal ; Ayyanar, Pavithra ; Garg, Sonika ; Aggarwal, Akash ; Sethy, Madhusmita ; Gowda, Shreya K.

Alopecia areata totalis and universalis are disabling conditions and therapeutically challenging as they are refractory to conventional options. Tofacitinib is a Janus-kinase (JAK) inhibitor utilized to treat alopecia areata (AA) as an off-label drug. In India, FDA-approved JAK inhibitors such as baricitinib and ritlecitinib are not available. There are only a few case reports on tofacitinib in AA in the Indian population. We present the data of 9 pediatric cases of clinically and histologically proven alopecia areata totalis (AT) and alopecia universalis (AU), for whom oral tofacitinib was given after baseline investigations. The following parameters were analysed: Photographic image and severity of alopecia tool (SALT) score at baseline, 3 months and 6 months, and Children Dermatology Life Quality Index (cDLQI) at baseline and 6 months. The mean ± standard deviation ( M ± SD) of the SALT score and cDLQI( M ± SD) at baseline were 95 ± 5 and 17 ± 2. At weeks 4 and weeks 12, the SALT ( M ± SD) score was 92.7 ± 6.1 and 34.35 ± 11.16, respectively. At weeks 24, the SALT ( M ± SD) score and cDLQI ( M ± SD) were 3.33 ± 5 and 6 ± 2. The final reduction in SALT score from the baseline was 100% in 6/9 cases (66.67%), 75% to 99% in 3/9 (22.23%), and 50 to 75% in 1/9 (11.12%). We also observed minimal adverse effects (one child developed herpes zoster) with tofacitinib. Our study demonstrates that oral tofacitinib represents a viable modality in managing difficult-to-treat pediatric AA, such as AT and AU, with a good safety profile.

01 Apr 2024·Journal of the European Academy of Dermatology and Venereology

European expert consensus statement on the systemic treatment of alopecia areata

Review

Author: Reygagne, P ; Grimalt, R ; Katoulis, A C ; Rudnicka, L ; Arenbergerova, M ; Rakowska, A ; Richard, M A ; Ovcharenko, Y S ; Lazaridou, E ; Soares, R O ; Olszewska, M ; Ioannides, D ; Vañó-Galvan, S ; Prohic, A ; Waskiel-Burnat, A ; Piraccini, B M ; Starace, M

AbstractAlopecia areata is an autoimmune form of non‐scarring hair loss. It is usually characterized by limited areas of hair loss. However, the disease may progress to complete scalp and body hair loss (alopecia totalis, alopecia universalis). In patients with alopecia areata hair loss significantly impacts the quality of life. Children and adolescents with alopecia areata often experience bullying, including physical aggression. The disease severity evaluation tools used in clinical practice are: the Severity of Alopecia Tool (SALT) score and the Alopecia Areata Scale (AAS). A SALT score equal to or greater than 20 constitutes a commonly accepted indication for systemic therapy in alopecia areata. When using the AAS, moderate to severe alopecia areata should be considered a medical indication for systemic treatment. Currently, the only two EMA‐approved medications for alopecia areata are baricitinib (JAK 1/2 inhibitor) for adults and ritlecitinib (JAK 3/TEC inhibitor) for individuals aged 12 and older. Both are EMA‐approved for patients with severe alopecia areata. Other systemic medications used off‐label in alopecia areata include glucocorticosteroids, cyclosporine, methotrexate and azathioprine. Oral minoxidil is considered an adjuvant therapy with limited data confirming its possible efficacy. This consensus statement is to outline a systemic treatment algorithm for alopecia areata, indications for systemic treatment, available therapeutic options, their efficacy and safety, as well as the duration of the therapy.

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