The Alopecia Areata Consensus of Experts (ACE) study: Results of an international expert opinion on treatments for alopecia areata - 19/06/20

Doi : 10.1016/j.jaad.2020.03.004

Nekma Meah, MBChB, MRCP (UK) ^a, Dmitri Wall, MBBCh, BAO, MRCP ^a, Katherine York, MBBCh, FCDerm (SA) ^b, Bevin Bhoyrul, MBBS, MRCP (UK) ^a, Laita Bokhari, MPhil Med ^a, Daniel Asz Sigall, MD ^c, Wilma F. Bergfeld, MD ^d, Regina C. Betz, MD ^e, Ulrike Blume-Peytavi, MD ^f, Valerie Callender, MD ^g, Vijaya Chitreddy, FACD ^a, Andrea Combalia, MD ^h, George Cotsarelis, MD ⁱ, Brittany Craiglow, MD ^j, Jeff Donovan, MD, PhD ^k, Samantha Eisman, MBChB, MRCP, FACD ^a, Paul Farrant, MBBS, BSc, MRCP ^l, Jack Green, FACD ^m, Ramon Grimalt, MD, PhD ⁿ, Matthew Harries, PhD, FRCP ^o, Maria Hordinsky, MD, FAAD ^p, Alan D. Irvine, MD, DSc ^q, Satoshi Itami, MD, PhD ^r, Victoria Jolliffe, MA(Cantab), FRCP, FRCS(Ed), MRCGP, SFHEA ^s, Brett King, MD, PhD ^t, Won-Soo Lee, MD, PhD ^u, Amy McMichael, MD ^v, Andrew Messenger, MD, FRCP ^w, Paradi Mirmirani, MD ^x, Elise Olsen, MD ^y, Seth J. Orlow, MD, PhD ^z,^aa, Bianca Maria Piraccini, MD, PhD ^bb, Adriana Rakowska, MD ^cc, Pascal Reygagne, MD ^dd, Janet L. Roberts, MD ^ee, Lidia Rudnicka, MD, PhD ^cc, Jerry Shapiro, MD, FAAD ^z, Pooja Sharma, MBBS, FACD ^a, Antonella Tosti, MD ^ff, Annika Vogt, MD ^gg, Martin Wade, FACD ^hh, Leona Yip, MBChB, PhD, FACD ⁱⁱ, Abraham Zlotogorski, MD ^jj, Rodney Sinclair, MBBS, MD, FACD ^a,^⁎
^a Sinclair Dermatology, East Melbourne, Melbourne, Australia
^b Netcare Greenacres Hospital, Port Elizabeth, South Africa
^c Dermalomas Clinic, Mexico City, Mexico
^d Departments of Dermatology and Pathology, Cleveland Clinic, Cleveland, Ohio
^e Institute of Human Genetics, School of Medicine & University Hospital Bonn, University of Bonn, Bonn, Germany
^f Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Charité–Universitätsmedizin Berlin, Berlin, Germany
^g Howard University College of Medicine, Washington, DC
^h Department of Dermatology, Hospital Clinic de Barcelona, Barcelona, Spain
ⁱ Department of Dermatology University of Pennsylvania School of Medicine Philadelphia, Philadelphia, Pennsylvania
^j Dermatology Physicians of Connecticut, Fairfield, Connecticut
^k Donovan Hair Clinic, Whistler, Canada
^l Brighton and Sussex University Hospitals Trust, Brighton, United Kingdom
^m St. Vincent's Hospital, Melbourne, Australia
ⁿ Facultat de Medicina i Ciències de la Salut, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
^o Department of Dermatology, Salford Royal NHS Foundation Trust, Manchester, United Kingdom
^p Dermatology, M Health Fairview Discovery Pediatric Specialty Clinic, Minneapolis, Minnesota
^q St. James's Hospital and National and International Sin Registry (NISR) Solutions, Dublin, Ireland
^r Department of Dermatology, Oita University, Yufu City, Japan
^s Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
^t Yale School of Medicine, Yale Dermatology, Middlebury, Connecticut
^u Department of Dermatology Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
^v Department of Dermatology, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina
^w Department of Infection, Immunity, and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
^x The Permanente Medical Group, Vallejo, California
^y Duke Dermatology Clinic, Durham, North Carolina
^z Director of Pediatric Dermatology, The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
^aa Department of Pediatrics, New York University Medical Center, New York, New York
^bb Deputy for International Relations, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
^cc Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
^dd Cabinet Pascal Reygagne (Lecourbe), Paris, France
^ee Northwest Dermatology Institute, Portland, Oregon
^ff Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
^gg Department of Dermatology, Venerology and Allergology, Charité Universitätsmedizin Berlin, Berlin, Germany
^hh The London Skin and Hair Clinic, London, United Kingdom
ⁱⁱ Gabba Dermatology, Brisbane, Australia
^jj Faculty of Medicine, Department of Dermatology, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel

^∗Rodney Sinclair, MBBS, MD, FACD, Sinclair Dermatology, 2 Wellington Parade, East Melbourne, Victoria 3002, Australia.Sinclair Dermatology2 Wellington ParadeEast MelbourneVictoria3002Australia

Abstract

Background

A systematic review failed to identify any systemic therapy used in alopecia areata (AA) where use is supported by robust evidence from high-quality randomized controlled trials.

Objective

To produce an international consensus statement on the use and utility of various treatments for AA.

Methods

Fifty hair experts from 5 continents were invited to participate in a 3-round Delphi process. Agreement of 66% or greater was considered consensus.

Results

In the first round, consensus was achieved in 22 of 423 (5%) questions. After a face-to-face meeting in round 3, overall, consensus was achieved for only 130 (33%) treatment-specific questions. There was greater consensus for intralesional treatment of AA (19 [68%]) followed by topical treatment (25 [43%]). Consensus was achieved in 45 (36%) questions pertaining to systemic therapies in AA. The categories with the least consensus were phototherapy and nonprescription therapies.

Limitations

The study included a comprehensive list of systemic treatments for AA but not all treatments used.

Conclusion

Despite divergent opinions among experts, consensus was achieved on a number of pertinent questions. The concluding statement also highlights areas where expert consensus is lacking and where an international patient registry could enable further research.

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Abbreviations used : AA, ACE, IL, ILC, JAK, RCT, SALT

Plan

Methods

Expert panel selection

Drs Meah and Wall are cofirst authors.

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Vol 83 - N° 1

P. 123-130 - juillet 2020 Retour au numéro

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The Alopecia Areata Consensus of Experts (ACE) study: Results of an international expert opinion on treatments for alopecia areata - 19/06/20

Abstract

Background

Objective

Methods

Results

Limitations

Conclusion

Plan

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