Treatments for alopecia areata: a network meta‐analysis.

Abstract

Background Alopecia areata is an autoimmune disease leading to nonscarring hair loss on the scalp or body. There are different treatments including immunosuppressants, hair growth stimulants, and contact immunotherapy.

Objectives To assess the benefits and harms of the treatments for alopecia areata (AA), alopecia totalis (AT), and alopecia universalis (AU) in children and adults.

Search methods The Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase, ClinicalTrials.gov and WHO ICTRP were searched up to July 2022.

Selection criteria We included randomised controlled trials (RCTs) that evaluated classical immunosuppressants, biologics, small molecule inhibitors, contact immunotherapy, hair growth stimulants, and other therapies in paediatric and adult populations with AA.

Data collection and analysis We used the standard procedures expected by Cochrane including assessment of risks of bias using RoB2 and the certainty of the evidence using GRADE. The primary outcomes were short‐term hair regrowth ≥ 75% (between 12 and 26 weeks of follow‐up), and incidence of serious adverse events. The secondary outcomes were long‐term hair regrowth ≥ 75% (greater than 26 weeks of follow‐up) and health‐related quality of life. We could not perform a network meta‐analysis as very few trials compared the same treatments. We presented direct comparisons and made a narrative description of the findings.