New Treatment for Alopecia Areata
What do you do with your most resistant alopecia areata patients? We have all been there and it can be very defeating as a patient and as a provider to see no progress or even worsening of the condition with “standard of care” treatments including intralesional and/or oral corticosteroids and topical immunotherapy. The data looks promising for a new treatment modality for alopecia areata.
A small study of approximately 30 patients was completed after an initial pilot study showed that simvastatin/ezetimibe (Vytorin, Merck & Co) successfully treated two alopecia universalis patients. Patients were given simvastatin/ezetimibe 40mg/10mg once a day alone for 24 weeks. Approximately 50% of patients (14 of 29 patients) were considered responders. Ten patients were lost to follow-up. No side effects were observed.
In the statistical analysis, a significant (p=.04) association was found between therapy and a stable remission. The authors predict that it is possible to see 50% remission in cases with alopecia areata for less than one year.
Statins are thought to be powerful, lymphocytic modulators by decreasing natural killer T cell toxicity resulting in an anti-inflammatory effect. Statins also inhibit MHC (major histocompatibility complex class II) and seem to block antigen 1 and intercellular adhesion molecule 1 from interacting. All thought to have positive effects on reducing inflammation and thus treating alopecia.
If you have been struggling to decide on the next step for your most resistant alopecia areata patients, simvastatin/ezetimibe appears to be a safe, promising new avenue.
By: Bethany Grubb, MPH, MPAS, PA-C; SDPA Diplomate; Past President
[Image: Carolyn Speranza]