Cytokine-Targeting Biologic Therapies for Alopecia Areata: A Comprehensive Review of Mechanism of Action, Clinical Efficacy, and Adverse Events

April 2025 in “ Biologics ”

Simonetta I. Gaumond, Isabella Kamholtz, Joaquín J. Jiménez

TLDR Dupilumab and ustekinumab are promising treatments for alopecia areata, showing significant hair regrowth.

Alopecia areata (AA) affects 2% of the global population, and while current treatments like corticosteroids and JAK inhibitors are effective, they have significant side effects. This review evaluates cytokine-targeting biologics as potential treatments for AA. Dupilumab and ustekinumab showed strong efficacy, with significant hair regrowth in 89% and 100% of cases, respectively. Tralokinumab showed a 33.75% improvement, but no patients achieved SALT50. Limited efficacy was observed with secukinumab, tildrakizumab, and adalimumab, with many patients showing no response. Etanercept and infliximab were associated with disease worsening in some cases. Further research is needed to optimize treatment protocols and discover new cytokine targets.

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Research cited in this study

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Alopecia areata involves immune activation in the scalp, suggesting treatments targeting TH1, TH2, and IL-23 pathways.

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