The Alopecia Areata Consensus of Experts (ACE) study: Results of an international expert opinion on treatments for alopecia areata.
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.
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, W-S; 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
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