Intramuscular Corticosteroid Therapy Safe, Effective for Treatment of Alopecia Areata

Intramuscular corticosteroid therapy (ICT) is a safe and effective treatment for patients with alopecia areata (AA), but disease recurrence is high after therapy is discontinued, according to results of a recent study.

In a retrospective cohort study, researchers at the Dermatology Clinic of Ramathibodi Hospital, Bangkok, Thailand determined the effectiveness, safety, dosing, and optimal duration of intramuscular corticosteroids (IMC) as a treatment for AA. A time-to-event analysis was performed on patients with severe, extensive, or rapidly progressive AA receiving an IMC regimen composed of triamcinolone acetonide 20-40 mg/mL injected every 4 to 6 weeks. Outcomes included initial, significant, and complete hair regrowth, defined as 25% regrowth, 75% regrowth and 100% regrowth respectively.

In a total of 101 patients analyzed, 80.2% (n = 81) experienced significant hair growth in a median time of 3.4 months (95% CI = 2.9-4.4). A total of 48.5% (n = 49) of patients experienced complete hair regrowth. Relapse was observed in 47.5% (n=48) of patients. Acneiform eruption was the most common adverse effect and nail involvement was a negative predictor of hair regrowth (adjusted HR = 0.04, 95% CI = 0.01-0.55). A disease duration of >6 months was associated with disease recurrence (adjusted HR = 4.02, 95% CI = 1.52-4.66, P = 0.005).

“This study demonstrated the efficacy and safety of IMC in the treatment of severe or active AA; however, the relapse rate remained relatively high after discontinuation of the therapy,” concluded the study authors.

Reference
Chanprapaph K, Pomsoong C, Kositkuljorn C, Suchonwanit P. Intramuscular corticosteroid therapy in the treatment of alopecia areata: A time-to-event analysis. Drug Des Devel Ther. 2022;16:107-116. doi:10.2147/DDDT.S342179