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

Nekma Meah; Dmitri Wall; Katherine York; Bevin Bhoyrul; Laita Bokhari; Daniel Asz Sigall; Wilma F. Bergfeld; Regina C. Betz; Ulrike Blume-Peytavi; Valerie Callender; Vijaya Chitreddy; Andrea Combalia; George Cotsarelis; Brittany Craiglow; Jeff Donovan; Samantha Eisman; Paul Farrant; Jack Green; Ramon Grimalt; Matthew Harries; Maria Hordinsky; Alan D. Irvine; Satoshi Itami; Victoria Jolliffe; Brett King; Won Soo Lee; Amy McMichael; Andrew Messenger; Paradi Mirmirani; Elise Olsen; Seth J. Orlow; Bianca Maria Piraccini; Adriana Rakowska; Pascal Reygagne; Janet L. Roberts; Lidia Rudnicka; Jerry Shapiro; Pooja Sharma; Antonella Tosti; Annika Vogt; Martin Wade; Leona Yip; Abraham Zlotogorski; Rodney Sinclair

doi:10.1016/j.jaad.2020.03.004

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

Nekma Meah, Dmitri Wall, Katherine York, Bevin Bhoyrul, Laita Bokhari, Daniel Asz Sigall, Wilma F. Bergfeld, Regina C. Betz, Ulrike Blume-Peytavi, Valerie Callender, Vijaya Chitreddy, Andrea Combalia, George Cotsarelis, Brittany Craiglow, Jeff Donovan, Samantha Eisman, Paul Farrant, Jack Green, Ramon Grimalt, Matthew HarriesMaria Hordinsky, Alan D. Irvine, Satoshi Itami, Victoria Jolliffe, Brett King, Won Soo Lee, Amy McMichael, Andrew Messenger, Paradi Mirmirani, Elise Olsen, Seth J. Orlow, Bianca Maria Piraccini, Adriana Rakowska, Pascal Reygagne, Janet L. Roberts, Lidia Rudnicka, Jerry Shapiro, Pooja Sharma, Antonella Tosti, Annika Vogt, Martin Wade, Leona Yip, Abraham Zlotogorski, Rodney Sinclair

Dermatology

Research output: Contribution to journal › Article › peer-review

54 Scopus citations

Abstract

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: To produce an international consensus statement on the use and utility of various treatments for AA. 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: 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: The study included a comprehensive list of systemic treatments for AA but not all treatments used. Conclusion: 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.

Original language	English (US)
Pages (from-to)	123-130
Number of pages	8
Journal	Journal of the American Academy of Dermatology
Volume	83
Issue number	1
DOIs	https://doi.org/10.1016/j.jaad.2020.03.004
State	Published - Jul 2020

Bibliographical note

Funding Information:
The authors would like to acknowledge financial support from the Australasian Hair and Wool Research Society , and for resource support from National and International Skin Registry (NISR) Solutions not-for-profit company (Dublin, Ireland) and The City of Dublin Skin and Cancer Hospital Charity (Dublin, Ireland).

Publisher Copyright:
© 2020 American Academy of Dermatology, Inc.

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10.1016/j.jaad.2020.03.004

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Meah, N., Wall, D., York, K., Bhoyrul, B., Bokhari, L., Sigall, D. A., Bergfeld, W. F., Betz, R. C., Blume-Peytavi, U., Callender, V., Chitreddy, V., Combalia, A., Cotsarelis, G., Craiglow, B., Donovan, J., Eisman, S., Farrant, P., Green, J., Grimalt, R., ... Sinclair, R. (2020). The Alopecia Areata Consensus of Experts (ACE) study: Results of an international expert opinion on treatments for alopecia areata. Journal of the American Academy of Dermatology, 83(1), 123-130. https://doi.org/10.1016/j.jaad.2020.03.004

Meah, N, Wall, D, York, K, Bhoyrul, B, Bokhari, L, Sigall, DA, Bergfeld, WF, Betz, RC, Blume-Peytavi, U, Callender, V, Chitreddy, V, Combalia, A, Cotsarelis, G, Craiglow, B, Donovan, J, Eisman, S, Farrant, P, Green, J, Grimalt, R, Harries, M, Hordinsky, M, Irvine, AD, Itami, S, Jolliffe, V, King, B, Lee, WS, McMichael, A, Messenger, A, Mirmirani, P, Olsen, E, Orlow, SJ, Piraccini, BM, Rakowska, A, Reygagne, P, Roberts, JL, Rudnicka, L, Shapiro, J, Sharma, P, Tosti, A, Vogt, A, Wade, M, Yip, L, Zlotogorski, A & Sinclair, R 2020, 'The Alopecia Areata Consensus of Experts (ACE) study: Results of an international expert opinion on treatments for alopecia areata', Journal of the American Academy of Dermatology, vol. 83, no. 1, pp. 123-130. https://doi.org/10.1016/j.jaad.2020.03.004

@article{98a980e51ae5494aa5caceb5f2b77ccc,

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

abstract = "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: To produce an international consensus statement on the use and utility of various treatments for AA. 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: 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: The study included a comprehensive list of systemic treatments for AA but not all treatments used. Conclusion: 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.",

author = "Nekma Meah and Dmitri Wall and Katherine York and Bevin Bhoyrul and Laita Bokhari and Sigall, {Daniel Asz} and Bergfeld, {Wilma F.} and Betz, {Regina C.} and Ulrike Blume-Peytavi and Valerie Callender and Vijaya Chitreddy and Andrea Combalia and George Cotsarelis and Brittany Craiglow and Jeff Donovan and Samantha Eisman and Paul Farrant and Jack Green and Ramon Grimalt and Matthew Harries and Maria Hordinsky and Irvine, {Alan D.} and Satoshi Itami and Victoria Jolliffe and Brett King and Lee, {Won Soo} and Amy McMichael and Andrew Messenger and Paradi Mirmirani and Elise Olsen and Orlow, {Seth J.} and Piraccini, {Bianca Maria} and Adriana Rakowska and Pascal Reygagne and Roberts, {Janet L.} and Lidia Rudnicka and Jerry Shapiro and Pooja Sharma and Antonella Tosti and Annika Vogt and Martin Wade and Leona Yip and Abraham Zlotogorski and Rodney Sinclair",

note = "Funding Information: The authors would like to acknowledge financial support from the Australasian Hair and Wool Research Society , and for resource support from National and International Skin Registry (NISR) Solutions not-for-profit company (Dublin, Ireland) and The City of Dublin Skin and Cancer Hospital Charity (Dublin, Ireland). Publisher Copyright: {\textcopyright} 2020 American Academy of Dermatology, Inc.",

year = "2020",

month = jul,

doi = "10.1016/j.jaad.2020.03.004",

language = "English (US)",

volume = "83",

pages = "123--130",

journal = "Journal of the American Academy of Dermatology",

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number = "1",

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T1 - The Alopecia Areata Consensus of Experts (ACE) study

T2 - Results of an international expert opinion on treatments for alopecia areata

AU - Meah, Nekma

AU - Wall, Dmitri

AU - York, Katherine

AU - Bhoyrul, Bevin

AU - Bokhari, Laita

AU - Sigall, Daniel Asz

AU - Bergfeld, Wilma F.

AU - Betz, Regina C.

AU - Blume-Peytavi, Ulrike

AU - Callender, Valerie

AU - Chitreddy, Vijaya

AU - Combalia, Andrea

AU - Cotsarelis, George

AU - Craiglow, Brittany

AU - Donovan, Jeff

AU - Eisman, Samantha

AU - Farrant, Paul

AU - Green, Jack

AU - Grimalt, Ramon

AU - Harries, Matthew

AU - Hordinsky, Maria

AU - Irvine, Alan D.

AU - Itami, Satoshi

AU - Jolliffe, Victoria

AU - King, Brett

AU - Lee, Won Soo

AU - McMichael, Amy

AU - Messenger, Andrew

AU - Mirmirani, Paradi

AU - Olsen, Elise

AU - Orlow, Seth J.

AU - Piraccini, Bianca Maria

AU - Rakowska, Adriana

AU - Reygagne, Pascal

AU - Roberts, Janet L.

AU - Rudnicka, Lidia

AU - Shapiro, Jerry

AU - Sharma, Pooja

AU - Tosti, Antonella

AU - Vogt, Annika

AU - Wade, Martin

AU - Yip, Leona

AU - Zlotogorski, Abraham

AU - Sinclair, Rodney

N1 - Funding Information: The authors would like to acknowledge financial support from the Australasian Hair and Wool Research Society , and for resource support from National and International Skin Registry (NISR) Solutions not-for-profit company (Dublin, Ireland) and The City of Dublin Skin and Cancer Hospital Charity (Dublin, Ireland). Publisher Copyright: © 2020 American Academy of Dermatology, Inc.

PY - 2020/7

Y1 - 2020/7

N2 - 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: To produce an international consensus statement on the use and utility of various treatments for AA. 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: 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: The study included a comprehensive list of systemic treatments for AA but not all treatments used. Conclusion: 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.

AB - 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: To produce an international consensus statement on the use and utility of various treatments for AA. 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: 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: The study included a comprehensive list of systemic treatments for AA but not all treatments used. Conclusion: 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.

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

Abstract

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