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Alopecia AreataPhase 4NCT04793945

Excimer Light and Topical Steroid in Treatment of Alopecia Areata

A Phase 4 study testing topical steroid and 308nm-Excimer light therapy in people with Alopecia Areata, run by Assiut University.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Alopecia areata is a polygenic autoimmune disease causing hair loss, particularly during the anagen phase of hair growth This condition has a lifetime risk of about 2.1% of the world population and the cumulative incidence seems to rise linearly with age . Read more about this study

Who is it for?
Ages 16 to 40 years
Conditions the study is for
Alopecia Areata
What is being tested?
topical steroid and 308nm-Excimer light therapy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
No sites listed yet
Study dates
1 Apr 2021to 30 Sep 2022
Phase
Phase 4
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 16 to 40 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • aged 16-40 years,
  • Good general health,
  • A clinical diagnosis of multiple Alopecia Areata of the scalp.
  • Hair loss <25 percent of the total scalp.
  • No use of drugs or hair care products influencing hair growth in the last 2 months.

Who cannot join

  • Other causes of hair loss (like endocrine or immunological diseases).
  • Skin disease in the treatment area.
  • Pregnant or lactating patients.
  • Hair transplantation history.
  • Photosensitivity history.
  • Malignant tumor history.

Trial locations and contacts

No sites are listed yet.

eman R mohamed hofny, professor contact

01005298992 ext. 002

e_riad@yahoo.com

yasmeen M tawfik mhany, PHD contact

01006033331 ext. 002

dr.yasminmostawfik@yahoo.com

About this study

Official title: The Efficacy of Combining 308 Nm-Excimer Light and Topical Steroid in the Treatment of Alopecia Areata

Alopecia areata is a polygenic autoimmune disease causing hair loss, particularly during the anagen phase of hair growth This condition has a lifetime risk of about 2.1% of the world population and the cumulative incidence seems to rise linearly with age .

Patchy non scarring hair loss on the scalp is the most common clinical presentation, although it can also occur elsewhere . In addition to patchy Alopecia Areata , a more severe form, alopecia totalis , presents with diffuse hair loss across the scalp. In the most severe form, alopecia universalis , hair loss occurs on all areas of the body, including the beard, eyelashes, and extremities .

Read the detailed description

Alopecia Areata can have a large impact on patients' quality of life, causing both cosmetic and psychosocial distress. Studies on the impact of hair loss have shown high levels of self-consciousness, jealousy, embarrassment, depression, introversion, and decreased self-esteem .

Alopecia Areata can occur at any age, but it is most common among young and middle-aged people . Both sexes are equally affected. Several environmental factors have been suggested as triggering Alopecia Areata, including infection, drugs, trauma, and stress. Thyroid autoimmune disease, atopy, and vitiligo are commonly associated. Diverse physical or psychological insults may trigger the episodes of Alopecia Areata, but there is no evidence that they influence prognosis.

Etiology of Alopecia Areata is not completely understood, and the majority of evidence suggests that genetically predisposed individuals, when exposed to an unknown trigger, develop a predominantly autoimmune reaction, leading to acute hair loss.

Although many patients improve spontaneously or respond to standard therapy, treatment can be quite challenging in those with more severe and refractory disease .

Topical corticosteroids are often the first line of treatment for mild patchy alopecia, with the underlying mechanism being containment of inflammation and hastening of the recovery of damaged hair follicles . Additionally, corticosteroids may be delivered via intralesional injection with slightly better effects (63% with complete regrowth within 4 months in one study . However, this method cannot be used for rapidly progressing variants and does not prevent hair loss at other sites . Furthermore, both topical and intralesional steroids increase the risk of cutaneous atrophy at the site of treatment, and intralesional steroids may decrease bone mineral density .

With the development of new technologies, more and more lasers or lamps have been used to treat alopecia, such as ultraviolet , Excimer laser/lamp , low-level laser , erbium-glass laser, thulium laser , and carbon dioxide laser . Individual researchers have been considering 308-nm Excimer lamp to be used for treating Alopecia Areata by inducing apoptosis of T lymphocytes, but the effective rates had differences in studies .

Excimer laser using high-dose monochromatic UV radiation can trigger apoptosis and induce immunological suppression through altering cytokine production such as interleukin-4, interleukin-10, prostaglandin E2, platelet-activating factor, and cis-urocanic acid .

Conditions
Alopecia Areata
Being tested
topical steroid and 308nm-Excimer light therapy
Medical subject headings
Alopecia Areata

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • topical steroid and 308nm-Excimer light therapyCombination product

    applying topical steroid in combination with 308nm-Excimer light therapy to treat Alopecia Areata

Study groups in NCT04793945
Study groupRoleWhat they receive
light therapy twice weeklyActive comparator15 or half of the patients with three patches of Alopecia Areata on the scalp the first patch will be treated by 308nm Excimer light twice weekly and topical steroid twice daily the second patch will be treated by topical steroid twice daily. the third patch will be left as a control.
Receives: Combination Product: topical steroid and 308nm-Excimer light therapy
light therapy once weeklyActive comparator15 or half of the patients with three patches of Alopecia Areata on the scalp the first patch will be treated by 308nm Excimer light once weekly and topical steroid twice daily. the second patch will be treated by topical steroid twice daily. the third patch will be left as a control.
Receives: Combination Product: topical steroid and 308nm-Excimer light therapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Severity of ALopecia Tool score

    The scalp is divided into four parts on the basis of surface area as follows: vertex or top = 40 percent (0.40), right side = 18 percent (0.18), left side = 18 percent (0.18) and the posterior aspect = 24 percent (0.24). Percentage of hair loss in any of the four areas was multiplied by the percentage of the scalp covered in that area. The Severity of Alopecia Tool score is the sum of the percentage of hair loss in all the areas mentioned above.[10]

    Measured: 9months

  2. digital photographs

    using identical camera settings, lighting, patient positioning and background.

    Measured: 9months

  3. The hair regrowth in the patches of alopecia

    0 = no hair regrowth,

    1. = 1-25percent hair regrowth,
    2. = 26-50percent hair regrowth,
    3. = 51-75percent hair regrowth, and
    4. = 76-100 percent hair regrowth.

    Measured: 9months

  4. Dermoscopic evaluation

    Dermoscopy will be used to analyze the change in the count of hair at intervals of 4 weeks. The number of hair (total, vellus, and terminal hairs) will be calculated by dermoscopy .

    Measured: 9months

  5. A patient satisfaction score

    0 to 25percent change = not satisfied, 26 to 50percent = mildly satisfied, 51 to 75percent = moderately satisfied, 76 to 100percent = very satisfied

    Measured: 9months

  6. adverse effects

    Any encountered adverse effects in terms of pain, erythema, edema and crusts will be recorded.

    Measured: 9months

  7. dermoscopic evaluation

    The mean diameter of hair will be recorded for analysis.

    Measured: 9months

  8. dermoscopic evaluation

    diameter of hair will be measured

    Measured: 9months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Mar 2021
  2. Study start1 Apr 2021 (estimated)
  3. Primary completion1 Apr 2022 (estimated)
  4. Study completion30 Sep 2022 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
patients with three patches of Alopecia Areata the first patch will be treated by topical steroid and Excimer light the second patch will be treated by topical steroid only the third patch will be left as a control
Masking
None (open label)
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04793945
Sponsor's protocol ID
fmztaraaf
Status last verified
Mar 2021
First submitted
3 Mar 2021
Last updated
11 Mar 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes

Publications

  • Pratt CH, King LE Jr, Messenger AG, Christiano AM, Sundberg JP. Alopecia areata. Nat Rev Dis Primers. 2017 Mar 16;3:17011. doi: 10.1038/nrdp.2017.11.

    PubMed 28300084
  • Mirzoyev SA, Schrum AG, Davis MDP, Torgerson RR. Lifetime incidence risk of alopecia areata estimated at 2.1% by Rochester Epidemiology Project, 1990-2009. J Invest Dermatol. 2014 Apr;134(4):1141-1142. doi: 10.1038/jid.2013.464. Epub 2013 Nov 11. No abstract available.

    PubMed 24202232
  • Villasante Fricke AC, Miteva M. Epidemiology and burden of alopecia areata: a systematic review. Clin Cosmet Investig Dermatol. 2015 Jul 24;8:397-403. doi: 10.2147/CCID.S53985. eCollection 2015.

    PubMed 26244028
  • Hordinsky MK. Overview of alopecia areata. J Investig Dermatol Symp Proc. 2013 Dec;16(1):S13-5. doi: 10.1038/jidsymp.2013.4.

    PubMed 24326541
  • Girman CJ, Hartmaier S, Roberts J, Bergfeld W, Waldstreicher J. Patient-perceived importance of negative effects of androgenetic alopecia in women. J Womens Health Gend Based Med. 1999 Oct;8(8):1091-5. doi: 10.1089/jwh.1.1999.8.1091.

    PubMed 10565667
  • Wells PA, Willmoth T, Russell RJ. Does fortune favour the bald? Psychological correlates of hair loss in males. Br J Psychol. 1995 Aug;86 ( Pt 3):337-44. doi: 10.1111/j.2044-8295.1995.tb02756.x.

    PubMed 7551645
  • Al Hamzawi NK. Evaluation of the Efficacy and Safety of 308-nm Monochromatic Excimer Lamp in the Treatment of Resistant Alopecia Areata. Int J Trichology. 2019 Sep-Oct;11(5):199-206. doi: 10.4103/ijt.ijt_74_19.

    PubMed 31728102
  • McElwee KJ, Gilhar A, Tobin DJ, Ramot Y, Sundberg JP, Nakamura M, Bertolini M, Inui S, Tokura Y, King LE Jr, Duque-Estrada B, Tosti A, Keren A, Itami S, Shoenfeld Y, Zlotogorski A, Paus R. What causes alopecia areata? Exp Dermatol. 2013 Sep;22(9):609-26. doi: 10.1111/exd.12209.

    PubMed 23947678
  • Olsen EA, Hordinsky MK, Price VH, Roberts JL, Shapiro J, Canfield D, Duvic M, King LE Jr, McMichael AJ, Randall VA, Turner ML, Sperling L, Whiting DA, Norris D; National Alopecia Areata Foundation. Alopecia areata investigational assessment guidelines--Part II. National Alopecia Areata Foundation. J Am Acad Dermatol. 2004 Sep;51(3):440-7. doi: 10.1016/j.jaad.2003.09.032. No abstract available.

    PubMed 15337988
  • Messenger AG, McKillop J, Farrant P, McDonagh AJ, Sladden M. British Association of Dermatologists' guidelines for the management of alopecia areata 2012. Br J Dermatol. 2012 May;166(5):916-26. doi: 10.1111/j.1365-2133.2012.10955.x. No abstract available.

    PubMed 22524397
  • 12. Kranseler, J. S. & Sidbury, R. 2017. Alopecia Areata: Update on Management. Indian Journal of Paediatric Dermatology, 18, 261.

  • Charuwichitratana S, Wattanakrai P, Tanrattanakorn S. Randomized double-blind placebo-controlled trial in the treatment of alopecia areata with 0.25% desoximetasone cream. Arch Dermatol. 2000 Oct;136(10):1276-7. doi: 10.1001/archderm.136.10.1276. No abstract available.

    PubMed 11030789
  • Kubeyinje EP. Intralesional triamcinolone acetonide in alopecia areata amongst 62 Saudi Arabs. East Afr Med J. 1994 Oct;71(10):674-5.

    PubMed 7821250
  • Samrao A, Fu JM, Harris ST, Price VH. Bone mineral density in patients with alopecia areata treated with long-term intralesional corticosteroids. J Drugs Dermatol. 2013 Feb;12(2):e36-40.

    PubMed 23377403
  • Herz-Ruelas ME, Welsh O, Gomez-Flores M, Welsh E, Miranda-Maldonado I, Ocampo-Candiani J. Ultraviolet A-1 phototherapy as an alternative for resistant alopecia areata. Int J Dermatol. 2015 Oct;54(10):e445-7. doi: 10.1111/ijd.13054. No abstract available.

    PubMed 26394604

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing topical steroid and 308nm-Excimer light therapy in people with Alopecia Areata, run by Assiut University.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 11 Mar 2021. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact eman R mohamed hofny, professor (01005298992 ext. 002, e_riad@yahoo.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Severity of ALopecia Tool score (time frame: 9months). The study lists 8 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04793945, which also lists 24 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Mar 2021.

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