Recent Changes to Evidence-Based Care for Alopecia Areata, with Arash Mostaghimi, MD, MPH

In a presentation at the American Academy of Dermatology (AAD) Annual Meeting titled ‘Great Care for Common Conditions: Combining Evidence and Cost Effectiveness,’ Arash Mostaghimi, MD, spoke as 1 of several panelists on therapies and evidence-based care for alopecia areata.

Mostaghimi, known for his work as the vice chair of Clinical Trials and Innovation at the Brigham & Women's Hospital Department of Dermatology, spoke with the HCPLive editorial team about the takeaways from his AAD presentation.

“The thing that's really different about alopecia areata now, relative to where we were several years ago, is that we're making a transition from theory and potential to evidence and real data,” Mostaghimi said. “So when you see a patient, you meet with them, we can now tell them…across the population, what they can expect at 6 months, 9 months, even out to 2 years or 3 years, etc. We need to know the appropriate time to start medications.”

Mostaghimi added that there is currently a significant amount of evidence around which patients are early responders, late responders, and how clinicians can predict some patients’ trajectories they're along their course. He also pointed to less discussed means of helping patients manage their alopecia.

“While these new therapies have replaced a lot of the older, more toxic, and less effective therapies, I think we still have to remember that we are doctors and the primary impact of alopecia ariata is psychosocial,” Mostaghimi explained. “So connecting with your patients on an individual level, providing them with emotional health support throughout their journey, and then connecting them with mental health resources, online support groups, patient advocacy groups such as NAF, the National Alopecia Areata Foundation, are critical things that we need to keep on doing, even as we're using new and different medications.”

Mostaghimi also highlighted recent changes in the dermatology space with regard to data on therapies available for alopecia.

“For all these medications, let's imagine cyclosporine, methotrexate, contact therapy, you may have a group of people, 5%, 10%, 15% who may respond to these medications,” Mostaghimis said. “But that was a guess. You didn't know who was going to respond, how they were going to tolerate medicine, and how it was going to work. Now that we have better data, we're not quite at yet the point where we can do a test on you and say ‘this is the perfect medication for you,’ but we have a lot more evidence for what works, how it works, and what to look out for with regard to risk to minimize the downsides of side effects.”

For any additional information from Mostaghimi’s talk on alopecia areata, view the full video interview posted above. To learn more about data presented at AAD, view our latest conference coverage.

The quotes contained in this interview summary were edited for clarity. Mostaghimi’s disclosures are as follows: Consultant (Fees): AbbVie, ACOM, Boehringer Ingelheim, Digital Diagnostics, Equillium, Pfizer; Advisory Board (Fees): Eli Lilly, Olaplex, Pelage Pharmaceuticals, Pfizer, Sun Pharmaceutical Industries; Advisory Board (Stock): Figure 1 Beauty, hims; Investigator (Grants/Research Funding): Eli Lilly, Incyte; Speaker (Fees): Boehringer Ingelheim.