Efficacy of Oral Apremilast in The Treatment of Alopecia Areata, at The Tertiary Care Hospital, Karachi
Main Article Content
Abstract
Background: Alopecia Areata (AA) presents a significant challenge in dermatology due to its unpredictable nature and psychological impact. Recent studies have focused on oral Apremilast, a phosphodiesterase 4 inhibitor, for its potential efficacy in treating AA.
Objective: This study aims to assess the efficacy of oral Apremilast in treating alopecia areata at a tertiary care hospital in Karachi.
Methods: A randomized controlled trial was conducted in the Department of Dermatology at Jinnah Postgraduate Medical Centre, Karachi, from August 2022 to June 2023. The study enrolled 85 patients exhibiting various symptoms of AA. Apremilast was administered orally at 30 mg twice daily, following a 5-day initial titration dose. The Severity of Alopecia Tool (SALT score) was employed to measure treatment effectiveness at the outset, 6 weeks, and 12 weeks. Data analysis was executed using SPSS version 23.
Results: Participants had an average age of 28.34 years (SD = 4.20), with a gender distribution of 51 women (60.0%) and 34 men (40.0%). The study demonstrated a significant decrease in SALT Scores from 62.42 ± 5.17 to 41.53 ± 13.44 at Week 12 (mean difference: 20.89, 95% CI: 17.86 to 23.92, p-value: 0.0001), indicating a notable reduction in AA severity. Oral apremilast was found to be effective in treating AA in 80.0% of patients.
Conclusion: The study concludes that oral Apremilast significantly reduces the severity of alopecia areata, as evidenced by the decline in SALT Scores from baseline to Week 12. These findings suggest that oral Apremilast may serve as a viable alternative treatment for AA, deserving further clinical exploration.
Article Details
![Creative Commons License](http://i.creativecommons.org/l/by/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Al Santali A. Alopecia areata: a new treatment plan. Clin Cosmet Investig Dermatol. 2011;4:107-15.
Tan E, Tay YK, Giam YC. A clinical study of childhood alopecia areata in Singapore. Pediatr Dermatol. 2002;19:298-301.
Tosti A, Bellavista S, Iorizzo M. Alopecia areata: A long term follow-up study of 191 patients. J Am Acad Dermatol. 2006;55:438-41.
Galán-Gutiérrez M, Rodríguez-Bujaldón A, Moreno-Giménez JC. Update on the treatment of alopecia areata. Actas Dermosifiliogr. 2009;100:266-76.
Wang E, Lee JS, Tang M. Current treatment strategies in pediatric alopecia areata. Indian J Dermatol. 2012;57:459-65.
García Hernández MJ, Camacho Martínez F. Epidemiología clínica de la alopecia areata. Actas Dermosifiliogr. 2002;93:223-8.
MacDonald Hull SP, Wood ML, Hutchinson PE, Sladden M, Messenger AG; British Association of Dermatologists. Guidelines for the management of alopecia areata. Br J Dermatol. 2003;149:692-9.
Finner AM. Alopecia areata: clinical presentation, diagnosis, and unusual cases. Dermatol Clin. 2011;24(3):348–54.
Al-Mutairi N, Eldin ON. Clinical profile and impact on quality of life: seven years experience with patients of alopecia areata. Indian J Dermatol Venereol Leprol. 2011;77(4):489–93.
Ito T. Advances in the management of alopecia areata. J Dermatol. 2012;39(1):11–7.
Brzezinska-Wcislo L, Bergler-Czop B, Wcislo-Dziadecka D, Lis-Swiety A. New aspects of the treatment of alopecia areata. Postepy Dermatol Alergol. 2014;31(4):262-5.
Ullah F, Dawood M, Noor N, Hameed S. Efficacy of topical clobetasol propionate 0.05% ointment and topical tacrolimus 0.1% ointment in treatment of alopecia areata: RCT. Pak J Med Health Sci. 2022;16(06):133-4.
Pavlović MD, Milenković T, Dinčić E. Apremilast in patients with moderate-to-severe alopecia areata: a double-blind, randomized, placebo-controlled study. J Am Acad Dermatol. 2020;83(3):834–9.
Guttman-Yassky E, Ungar B, Noda S. Apremilast for the treatment of moderate-to-severe atopic dermatitis: A Phase II randomized trial. J Invest Dermatol. 2021;141(5):1150-9.e4.
Mesinkovska NA, Tosti A, Goldust M. The use of oral Apremilast in the treatment of alopecia areata. J Am Acad Dermatol. 2021;84(6):1589–96.
Mesinkovska NA, Tosti A, Goldust M. Long-term safety and efficacy of Apremilast in the treatment of moderate-to-severe alopecia areata: a retrospective study. J Am Acad Dermatol. 2022;86(1):123–9.
Jones SA, Orme ME, Saran R. Apremilast for moderate-to-severe alopecia areata: A randomized controlled trial. J Am Acad Dermatol. 2022;86(2):259-66.
Singh S, Khandpur S. Comparative efficacy of systemic treatments for moderate to severe alopecia areata: A systematic review. J Am Acad Dermatol. 2023;88(1):123-30.
Rigopoulos D, Gregoriou S, Stratigos A. Apremilast in the therapy of moderate-to-severe chronic plaque psoriasis. J Eur Acad Dermatol Venereol. 2023;37(4):774-9.
Fabbrini G, Abbruzzese G, Barone P. Adverse events during long-term use of Apremilast in Parkinson's disease. Mov Disord. 2023;38(4):771-8.
Taneja N, Gupta S. Apremilast is efficacious in refractory alopecia areata. J Dermatolog Treat. 2019.
Mikhaylov D, Pavel A, Yao C, Kimmel G, Nia J, Hashim P, et al. A randomized placebo-controlled single-center pilot study of the safety and efficacy of apremilast in subjects with moderate-to-severe alopecia areata. Arch Dermatolog Res. 2019;311:29-36.
Weber B, Radakovic S, Tanew A. Apremilast for extensive and treatment-resistant alopecia areata: a retrospective analysis of five patients. Eur J Dermatol. 2020;30:165-8.