The Alopecia Areata Consensus of Experts (ACE) study: Results of an international expert opinion on treatments for alopecia areata.

Administration, Oral Administration, Topical Adrenal Cortex Hormones / therapeutic use Age Factors Alopecia Areata / drug therapy Combined Modality Therapy Complementary Therapies Delphi Technique Dermatologic Agents / therapeutic use Expert Testimony Humans Injections, Intralesional Phototherapy Severity of Illness Index Treatment Outcome

Journal

Journal of the American Academy of Dermatology

ISSN: 1097-6787

Titre abrégé: J Am Acad Dermatol

Pays: United States

ID NLM: 7907132

Informations de publication

Date de publication:
Jul 2020

Historique:

received: 17 12 2019

revised: 26 01 2020

accepted: 02 03 2020

pubmed: 14 3 2020

medline: 20 1 2021

entrez: 14 3 2020

Statut: ppublish

Résumé

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. To produce an international consensus statement on the use and utility of various treatments for AA. Fifty hair experts from 5 continents were invited to participate in a 3-round Delphi process. Agreement of 66% or greater was considered consensus. 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. The study included a comprehensive list of systemic treatments for AA but not all treatments used. 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.

Sections du résumé

BACKGROUND 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 OBJECTIVE

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

METHODS 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 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 CONCLUSIONS

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

CONCLUSION CONCLUSIONS

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.

Identifiants

DOI: 10.1016/j.jaad.2020.03.004 PMID: 32165196

pubmed: 32165196

pii: S0190-9622(20)30375-3

doi: 10.1016/j.jaad.2020.03.004

pii:

doi:

Substances chimiques

Adrenal Cortex Hormones 0

Dermatologic Agents 0

Types de publication

Consensus Development Conference Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

123-130