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Patients with rapidly progressive alopecia displayed higher cure rate

Patients with alopecia areata with regenerated vellus hairs showed a significantly higher improvement or cure rate, as did patients with a rapidly progressive form of the condition, regardless of treatment modality, according to study results.

Researchers in Tokyo conducted a retrospective study of 1,030 patients with alopecia areata (AA) diagnosed between January 2005 and December 2007. Follow-up was at a clinic or by questionnaire, with questionnaires regarding the current status of hair loss given to rapidly progressive AA (RPAA) patients to assess long-term prognosis. Extent of hair loss on first visit and final exam were compared to measure the extent of improvement.

Of the 1,030 patients, 19.3% were diagnosed with RPAA and 80.7% were diagnosed with non-RPAA. One hundred ninety-four (18.8%) of all AA patients displayed complete or temporary cure within 1 year during follow-up. Three hundred-eleven patients were followed for 24 months or longer, including 128 RPAA patients and 60 patients with 50% hair loss or greater (severe AA). The results of multivariate analysis for the prognosis of the 311 patients showed that vellus hairs indicated significantly higher rate of improvement (OR=2.71; 05% CI, 1.35-5.43) and cure (OR=3.46; 95% CI, 1.86-6.43). Patients with disease duration of at least 6 months displayed a significantly higher relapse rate (OR=0.37; 95% CI, 0.14-0.94). Patients with RPAA showed higher improvement rate (OR=5.81; 95% CI, 2.87-11.77) and cure rate (OR=4.90; 95% CI, 2.82-8.52) and lower relapse rate (OR=0.37; 95% CI, 0.15-0.95). Patients with disease onset before age of 16 years had a significantly lower cure rate (OR=3.45; 95% CI, 1.52-7.81).

Study limitations included tracking by questionnaires was only for RPAA patients, follow-up duration was different depending on the cases, initial treatment was not randomized and treatment modalities were changed in some patients during follow-up, the researchers said.

“RPAA patients tend to show a favorable prognosis regardless of treatment modality,” the researchers concluded.