P100: Efficacy of current treatments under study in patients with alopecia areata
Bibliographic record
Abstract
Markqayne Ray,1 Maureen Neary,1 Bach-Khoa Vu,2 Harriet Tuson,3 Noor-E Zannat,2 Ernest Law,1 Karolina Wosik,4 Debanjali Mitra5 and Sharada Harricharan2 1Pfizer Inc., Collegeville, PA, USA; 2Cytel Inc., Waltham, MA, USA; 3Pfizer Ltd, Walton Oaks, UK; 4Pfizer Canada Inc., Kirkland, Canada; and 5Pfizer Inc., New York, NY, USA Alopecia areata (AA) is a nonscarring, chronic inflammatory disease characterized by hair loss ranging from small, well-defined patches to complete loss of scalp, facial and body hair. There are no approved treatments for AA across most major countries worldwide, while there is considerable patient burden and unmet need for effective therapies. This large systematic review study aimed to identify treatments currently being evaluated within clinical trials for AA and to summarize efficacy outcomes. Using PRISMA guidelines, clinical studies reporting efficacy in AA from January 2010 to October 2021 were identified in searches of Embase, MEDLINE and Cochrane. Publications from dermatology congresses (2019–2021) and ClinicalTrials.gov were also identified. Study design, population characteristics and efficacy outcomes were summarized descriptively. A total of 136 publications for 129 clinical studies (n = 7618) were selected for inclusion. Of these studies, 73 were randomized controlled trials (RCTs), 17 were nonrandomized trials and 39 were single-arm trials. Thirty-two studies evaluated exclusively adult cohorts (≥ 18 years) and three evaluated paediatrics (≤ 17 years, 2–18 years and < 16 years, respectively). No studies reported results by defined paediatric-age subsets, such as adolescents. Across 73 RCTs, 6120 patients were included (3–281 per arm), aged 6.4–52.5 years. The most frequently evaluated interventions (monotherapy/combinations) included corticosteroids (45%), Janus kinase (JAK) inhibitors (14%), phototherapy (13%), platelet-rich plasma (PRP; 12%) and diphenylcyclopropenone (DPCP; 8%). Commonly reported efficacy outcomes included the proportion of patients with hair growth (n = 81/129) and Severity of Alopecia Tool (SALT) score (n = 58/129). Mean relative percentage change from baseline in SALT score at 24 weeks was reported in 11 RCTs for patients receiving selected treatments, as follows: 7–52% for corticosteroids (n = 3), 31–64% for JAK inhibitors (ritlecitinib, brepocitinib, tofacitinib, baricitinib; n = 4), 1–9% for PRP (n = 3) and 35% for DPCP (n = 1). Sixteen studies evaluated patient-reported outcomes (PROs) using disease-specific and generic scales. Treatment satisfaction was the most frequently reported PRO across studies (n = 7/16), with most patients in these seven studies reporting moderate or better satisfaction. PRO measures for quality of life were much less frequently included, despite patient burden. While there is currently a lack of approved treatments in AA, numerous therapies have been studied. For treatments under study, promising efficacy results have been observed for JAK inhibitors. Few studies have evaluated treatments in adolescent patients, thereby indicating a need for future efficacy studies in this population. Additional studies that further evaluate patient-relevant endpoints will also be important to support holistic management of this condition.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.005 | 0.004 |
| Bibliometrics | 0.003 | 0.005 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".