Safety and Efficacy of Adalimumab for the Treatment of Severe Alopecia Areata: Case Series of Three Patients

Background: Current therapeutic options for extensive alopecia areata (AA) often lead to disappointing results. Objective: To study the efficacy and safety of adalimumab in patients with severe AA. Methods: This was a prospective, open-label, single-center, pilot study. Three subjects of the planned 10 were enrolled and received two weekly subcutaneous (SC) loading doses of adalimumab 80 mg followed by 40 mg SC every week for 6 months. Patients were evaluated for efficacy and safety on a monthly basis. Results: Enrolment in this trial was stopped following publication of studies showing no improvement in patients with AA treated with tumor necrosis factor α antagonists. One patient had a favorable response to adalimumab, whereas the two other patients had no benefit from the therapy. Adalimumab was well tolerated by patients with AA. Conclusion: Adalimumab was well tolerated in patients with AA but did not induce clinically significant hair regrowth.

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Tumor necrosis factor-α (TNFα) inhibitors in the treatment of nonradiographic axial spondyloarthritis: current evidence and place in therapy

Therapeutic Advances in Musculoskeletal Disease ◽

10.1177/1759720x17706454 ◽

2017 ◽

Vol 9 (8) ◽

pp. 197-210 ◽

Cited By ~ 7

Author(s):

Valeria Rios Rodriguez ◽

Denis Poddubnyy

Keyword(s):

Ankylosing Spondylitis ◽

Tumor Necrosis Factor ◽

Tumor Necrosis ◽

Tumor Necrosis Factor Α ◽

Axial Spondyloarthritis ◽

Efficacy And Safety ◽

Tnfα Inhibitors ◽

Factor Α ◽

Nonradiographic Axial Spondyloarthritis ◽

Necrosis Factor

Nonradiographic axial spondyloarthritis (SpA) and radiographic SpA (also known as ankylosing spondylitis) are currently considered as two stages or forms of one disease (axial SpA). The treatment with tumor necrosis factor-α (TNFα) inhibitors has been authorized for years for ankylosing spondylitis. In recent years, most of the anti-TNFα agents have also been approved for the treatment of nonradiographic axial SpA by the European Medicines Agency (EMA) and similar authorities in many countries around the world (but not in the US), increasing the number of possible therapies for this indication. Data from several clinical trials have demonstrated the good efficacy and safety profiles from those anti-TNFα agents. Presently, a large number of patients achieve a satisfactory clinical control with the current therapies, however, there remains a percentage refractory to nonsteroidal anti-inflammatory drugs (NSAIDs) and TNFα inhibitors; therefore, several new drugs are currently under investigation. In 2015, the first representative of a new class of biologics [an interleukin (IL)-17 inhibitor] secukinumab, was approved for the treatment of ankylosing spondylitis; a clinical trial in nonradiographic axial SpA is currently underway. In this review, we discuss the recent data on efficacy and safety of TNFα-inhibitors focusing on the treatment of nonradiographic axial SpA.

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