Which biological agents are used to treat alopecia areata?

Updated: Aug 06, 2020
  • Author: Chantal Bolduc, MD, FRCPC; Chief Editor: Dirk M Elston, MD  more...
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Answer

Data are mixed, with many prospective, randomized placebo-controlled studies [48, 49] and case reports published in the last few years regarding the use of biologic agents (including adalimumab, alefacept, etanercept, and infliximab) in the treatment of alopecia areata, failing to show efficacy, and some patients developed alopecia areata while under treatment with biologic agents for other conditions.

A 2019 randomized, placebo-controlled study that included 30 patients with greater than 50% involvement showed no benefit from these drugs for the treatment of alopecia areata. [50]

Systemic JAK inhibitors now have a significant body of data supporting their efficacy. Although results vary, it can be expected that 50% of patients will have greater than 50% regrowth. Treatment usually has to be continued to maintain efficacy. [51, 52, 53, 54, 55, 56, 57, 58, 59] A double-blind, randomized, vehicle-controlled study showed no efficacy of ruxolitinib cream for the treatment of alopecia areata. [60]

Dupilumab has been reported as both beneficial and detrimental in cases of alopecia areata, and there is no clear conclusion at this point. [61]

Oral alitretinoin shows some promise. [62]


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