Highlights from

American Academy of Dermatology

annual meeting 2018

San Diego 16-20 February 2018

New agents and combination therapy

Many new agents in the pipeline

Another interesting agent is a novel peptide that inhibits the cytokines IL-2, IL-9, and IL-15 (BNZ-1). Signalling of IL-4, IL-7, and IL-21 are unaffected by this peptide, which preserves immunological function (Figure 11). The agent BNZ-1 was effective in a mouse model of immune-mediated hair loss. It led to a reduction of the inflammatory cytokines IL-6, TNF-α and IFNγ and was able to restore hair growth. It proved to be safe in healthy volunteers and a Phase 2 randomised double-blind placebo-controlled dose ranging study in AA is planned in 2018.

“Many pharma companies are now interested in hair disorders and in the hair follicle as a model to study inflammatory pathways, so there is more to come in the next years,” said Prof. Wilma Bergfeld of the Cleveland Clinic

AAD 2018: Figure 11 Mode of action

Figure 11: Mode of action of the peptide BNZ-1

Combination therapy to enhance topical steroids

The efficacy of conventional therapy (topical steroids) can be improved by its combination with narrowband-UVB (NB-UVB) phototherapy [7]. This was shown in a randomised trial among adult Filipinos aged 18–60 that was presented as a late-breaking trial. 33 patients were randomly allocated into two treatment groups. Group A (n=17) applied clobetasol propionate 0.05% ointment twice daily and underwent NB-UVB thrice weekly for eight weeks. Group B (n=16) was treated with clobetasol alone. Therapeutic response was assessed at Weeks 2, 4, and 8 based on hair count.

At Week 8, Group A had a significantly higher mean hair count than Group B (P<0.0001). It was believed by 87.5% of patients in the intervention group that the intervention was markedly effective, compared to 18.75% from the placebo group (P<0.0001). Group A observed that their alopecic patches had improved notably while Group B failed to see significant improvement from baseline (P<0.0001). No adverse reactions were identified in both groups.

The authors conclude that NB-UVB phototherapy is a safe and effective adjuvant therapy for AA as it works synergistically with topical steroid in promoting hair growth without phototoxic reactions.

  1. Magsino-Songco P, Abstract 6752 , AAD Annual Meeting, February 16–20 2018.

The content and interpretation of these conference highlights are the views and comments of the speakers/authors.