Author Interviews, Dermatology, JAMA / 20.10.2014

Marie C. Leger, MD, PhD Ronald O. Perelman Department of Dermatology New York University School of Medicine, New YorkMedicalResearch.com Interview with Marie C. Leger, MD, PhD Ronald O. Perelman Department of Dermatology New York University School of Medicine, New York Medical Research: What are the main findings of the study?What was most surprising about the results?

 Dr. Leger: Alopecia areata is a T-cell mediated autoimmune disease. As such, there was initially hope that inhibiting the helper T cell cytokine TNF-α could effectively treat this condition. This has not been shown to be the case—in fact, one open-label study of etanercept in 17 patients with moderate to severe alopecia showed no hair regrowth and even worsening of alopecia in several subjects. There have been many other case reports in the dermatologic literature of TNF-α inhibitors causing alopecia areata. In contrast, our case report presents a patient who very clearly grew hair on adalimumab—its strength lies in the fact that her hair loss and regrowth were replicated on withdrawal and rechallenge with the medication. Our patient’s paradoxical response to adalimumab complements other literature suggesting that there are genetic variations in the way a patient’s immune system responds to TNF-α inhibitors. In different individuals, these medications can either treat or cause conditions such as psoriasis or lupus. It seems that this is also the case with alopecia areata. (more…)