Choi Joong-Woon, Suh Dong-Woo, Lew Bark-Lynn, Sim Woo-Young
Department of Dermatology, Kyung Hee University College of Medicine, Seoul, Korea.
Ann Dermatol. 2017 Dec;29(6):755-760. doi: 10.5021/ad.2017.29.6.755. Epub 2017 Oct 30.
Simvastatin belongs to the statin family, whose members have immunomodulatory activities. Ezetimibe have synergetic effects when co-administered with simvastatin. In several case reports, alopecia totalis and alopecia universalis were successfully treated with simvastatin/ezetimibe, suggesting that this combination could be a new efficient therapy for recalcitrant alopecia areata (AA).
To verify the efficacy of the simvastatin/ezetimibe combination therapy for recalcitrant AA and investigate the relationship between various treatment responses and prognostic factors.
This prospective open study was performed in patients with recalcitrant AA with the bald surface exceeding 75%. All patients took simvastatin (40 mg) and ezetimibe (10 mg) daily. The extent of hair regrowth expressed as percentage of the bald area was used to evaluate the effectiveness of the therapy.
Of 14 enrolled patients, 4 patients (28.6%) were judged as responders showing regrowth of 30% to 80% after 3 months of treatment. The mean age of onset in non-responders was significantly lower than in responders. The total score of prognostic factors, calculated as a sum of factors related to poor prognosis, was much lower in responders than in non-responders.
The remission rate in this study was unsatisfactory. However, since the recruited patients had not responded to any other treatments for AA, simvastatin/ezetimibe can still be considered as an alternative treatment for recalcitrant AA. The total scores of the prognostic factors were statistically different between responders and non-responders. These results can be used to predict the outcome of treatment with simvastatin/ezetimibe and anticipate prognosis.
辛伐他汀属于他汀类药物家族，其成员具有免疫调节活性。依折麦布与辛伐他汀联合使用时具有协同作用。在几例病例报告中，全秃和普秃患者使用辛伐他汀/依折麦布治疗成功，这表明该联合用药可能是治疗顽固性斑秃（AA）的一种新的有效疗法。
验证辛伐他汀/依折麦布联合疗法治疗顽固性AA的疗效，并研究各种治疗反应与预后因素之间的关系。
本前瞻性开放性研究针对秃发面积超过75%的顽固性AA患者进行。所有患者每日服用辛伐他汀（40毫克）和依折麦布（10毫克）。用秃发面积的毛发再生百分比来评估治疗效果。
14例入选患者中，4例（28.6%）被判定为有反应者，治疗3个月后毛发再生率为30%至80%。无反应者的平均发病年龄显著低于有反应者。预后因素总分（计算方法为与预后不良相关的因素之和）在有反应者中比无反应者低得多。
本研究中的缓解率不尽人意。然而，由于招募的患者对AA的任何其他治疗均无反应，辛伐他汀/依折麦布仍可被视为顽固性AA的替代治疗方法。有反应者和无反应者之间预后因素的总分在统计学上存在差异。这些结果可用于预测辛伐他汀/依折麦布治疗的结果并预测预后。
