Intralesional Steroids in the Treatment of Alopecia Areata

Last updated: June 5, 2019
Sponsor: Columbia University
Overall Status: Terminated

Phase

4

Condition

Hair Loss

Alopecia

Treatment

N/A

Clinical Study ID

NCT01898806
AAAI5852
  • Ages 18-75
  • All Genders

Study Summary

This study aims to determine the frequency of response to treatment with 3 concentrations of IL TAC, 2.5mg/ml, 5mg/ml or 10mg/ml as well as the duration of response and incidence of side effects compared to treatment with placebo (sterile saline solution). After the 1st 6 months, nonresponders or partial responders may be treated for 6 months with open label triamcinolone at the dose deemed appropriate by the investigator.

The investigators will also perform skin biopsies of the scalp and draw blood at selected time points in order to examine the immunohistochemical/pathological response in scalp hair follicles and the systemic circulation to treatment with IL TAC for alopecia areata.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Patients 18 to 75 years of age

  • Patients with a diagnosis of patch type alopecia areata

  • Patients will have up to 50% total scalp hair loss at baseline as measured by theSeverity of Alopecia Tool (SALT) score

  • Duration of hair loss ranging from 3 to 12 months with no evidence of regrowth presentat baseline in the areas to be injected

Exclusion

Exclusion Criteria:

  • Patients with a history of or existing skin diseases affecting the scalp such aspsoriasis or seborrheic dermatitis and patients with evidence of infection or skincancer in the treated areas

  • Patients in whom the diagnosis of alopecia areata is questionable

  • Patients in whom regrowth is present/evident at baseline in the areas to be treated

  • Patients with active medical conditions or malignancies (except adequately treatedbasal or squamous cell carcinoma of the skin) which in the opinion of the investigatorwould increase the risks associated with study participation, including patients witha history of recurrent infections

  • Women of childbearing potential who are unable or unwilling to use two forms of birthcontrol for the study duration or women who are pregnant or nursing

  • Patients known to be HIV or hepatitis B or C positive or otherwise immunocompromised

  • Patients with evidence of adrenal cortex abnormality or previous significant adversereaction to intralesional steroids

  • Patients unwilling or unable to discontinue treatments known to affect hair regrowthin alopecia areata

  • Patients who have been treated with intralesional steroids, systemic steroids,anthralin, squaric acid, diphenylcyclopropenone (DPCP), protopic, minoxidil or othermedication which in the opinion of the investigator may affect hair regrowth, withinone month of the baseline visit

Study Design

Total Participants: 11
Study Start date:
September 01, 2011
Estimated Completion Date:
January 31, 2018

Study Description

Alopecia areata (AA) is a major medical problem and is the most prevalent autoimmune disease in the US. AA represents the second most common form of hair loss and causes significant disfigurement and psychological distress to affected individuals. AA affects more individuals than most other autoimmune diseases combined, including lupus erythematosus, type 1 diabetes, psoriasis, multiple sclerosis and rheumatoid arthritis. In contrast to these conditions, research into the pathogenesis and the development of innovative therapies in AA has lagged behind.

Alopecia areata is a common form of hair loss which reportedly occurs in up to 1.7% of the population at some time in their life. Alopecia areata is apparently triggered when the individual's own immune system attacks hair follicles on the scalp or body resulting in hair loss ranging from single patches on the scalp (patch type alopecia areata) to loss of every hair on the scalp and body (alopecia universalis). Currently, there are limited treatment options for alopecia areata and unfortunately, the treatments utilized have never been rigorously tested in a placebo controlled trial.

Triamcinolone (Kenalog) is a steroid solution that has been used as a treatment for alopecia areata for over 50 years. It is administered via injection into the scalp and appears to have some efficacy for patients with mild to moderate alopecia areata. The investigators currently do not have objective data on the frequency of occurrence of successful regrowth, the duration of response or the incidence of side effects. Intralesional triamcinolone (IL TAC) is arguably the most commonly used treatments for AA, especially in patients with less than 50% hair loss. Despite this, there are no adequately powered, randomized controlled clinical trials (RCTs) examining the efficacy, safety, and duration of effect of IL TAC. In addition, the dosage or strength used varies among practitioners and the efficacy and safety of alternate doses of IL TAC has never been examined in a well designed RCT. Quantitative biomarkers for AA are a crucial step toward translational research aimed at clinical trials in AA.

Connect with a study center

  • University of Minnesota

    Minneapolis, Minnesota 55455
    United States

    Site Not Available

  • Columbia University Medical Center, Department of Dermatology

    New York, New York 10032
    United States

    Site Not Available

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