Hot Off the Press! Another Treatment Shows Promise in Alopecia Areata
Another treatment shows success in three patients according to an article just published in the Journal of Allergy and Clinical Immunology. Recent developments in alopecia areata research have pointed out the similarities it shares with other autoimmune diseases. This has been of large benefit, allowing researchers to test medications in alopecia areata that are already approved and proven safe in other conditions.
One such medication, ustekinumab, was tested by Dr. Emma Guttman-Yassky, and her research team at Mount Sinai hospital, NYC. Their new publication shows how extensive alopecia areata (AA) can be reversed by using ustekinumab. This medication works as an IL-12/23p40 cytokine antagonist, a cytokine found to be highly elevated in AA lesions. The researchers evaluated hair regrowth in three AA patients, with 40%-100% scalp hair loss. The patients were treated with 90mg ustekinumab subcutaneously at 0, 4, and 16 weeks. Patients were evaluated clinically using percent hair loss, and genomic modulation was analyzed using gene-arrays on scalp biopsies.
At 20 weeks, when hair regrowth was assessed, it occurred in all 3 patients, ranging from 25%, 62.5% to 85%. The highest regrowth was actually seen in the patient with alopecia universalis, and it ultimately reached 97% at 49 weeks!. After ustekinumab treatment, there was a decrease in inflammatory markers, and normalization of hair keratin and immune-related genes in scalp biopsies.
This is an exciting report about the use of ustekinumab in alopecia areata. What do we know about ustekinumab? This is a prescription medicine approved to treat adults 18 years and older with psoriatic arthritis, or moderate or severe plaque psoriasis. It is typically given as a 45 mg or 90 mg injection under the skin, dosed at weeks 0, 4, and every 12 weeks thereafter. As ustekinumab affects the immune system, it can lower the patient’s ability to fight infections and may increase risk of infections. Albeit very exciting, we should be aware that this is a small study, and that some past reports show alopecia areata occurring while patients were on ustekinumab therapy for other purposes. Currently, the team at Mount Sinai is conducting a larger study to test the efficacy ustekinumab in alopecia areata, and we are eagerly awaiting their results.
Author: Dr. Natasha Atanaskova Mesinkovska, Chief Scientific Officer