New agents and combination therapy

Many new agents in the pipeline

Another interesting agent is a novel peptide that inhibits the cytokines IL-2, IL-9, and IL-15 (BNZ-1). Signalling of IL-4, IL-7, and IL-21 are unaffected by this peptide, which preserves immunological function (see Figure). The agent BNZ-1 was effective in a mouse model of immune-mediated hair loss. It led to a reduction of the inflammatory cytokines IL-6, TNF-α and IFNγ and was able to restore hair growth. It proved to be safe in healthy volunteers and a Phase 2 randomised double-blind placebo-controlled dose ranging study in AA is planned in 2018.

Figure: Mode of action of the peptide BNZ-1

“Many pharma companies are now interested in hair disorders and in the hair follicle as a model to study inflammatory pathways, so there is more to come in the next years,” said Prof. Wilma Bergfeld of the Cleveland Clinic

Combination therapy to enhance topical steroids

The efficacy of conventional therapy (topical steroids) can be improved by its combination with narrowband-UVB (NB-UVB) phototherapy [7]. This was shown in a randomised trial among adult Filipinos aged 18–60 that was presented as a late-breaking trial. 33 patients were randomly allocated into two treatment groups. Group A (n=17) applied clobetasol propionate 0.05% ointment twice daily and underwent NB-UVB thrice weekly for eight weeks. Group B (n=16) was treated with clobetasol alone. Therapeutic response was assessed at Weeks 2, 4, and 8 based on hair count.

At Week 8, Group A had a significantly higher mean hair count than Group B (P<0.0001). It was believed by 87.5% of patients in the intervention group that the intervention was markedly effective, compared to 18.75% from the placebo group (P<0.0001). Group A observed that their alopecic patches had improved notably while Group B failed to see significant improvement from baseline (P<0.0001). No adverse reactions were identified in both groups.

The authors conclude that NB-UVB phototherapy is a safe and effective adjuvant therapy for AA as it works synergistically with topical steroid in promoting hair growth without phototoxic reactions.

7. Magsino-Songco P, Abstract 6752 , AAD Annual Meeting, February 16–20 2018.



Posted on 20 December 201817 May 2024