alexa Predictive model for immunotherapy of alopecia areata with diphencyprone.


Journal of Clinical & Experimental Dermatology Research

Author(s): Wiseman MC, Shapiro J, MacDonald N, Lui H, Wiseman MC, Shapiro J, MacDonald N, Lui H

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Abstract BACKGROUND: Immunotherapy with diphencyprone (diphenylcyclopropenone) is used in the treatment of alopecia areata (AA). Response rates have varied in the literature. OBJECTIVES: To determine the efficacy of diphencyprone therapy for AA in the largest reported cohort of patients; to identify patient and treatment factors predictive of therapeutic success; and to develop a practical model for predicting patient response. METHODS: The medical records of 148 consecutive patients treated with diphencyprone were reviewed. A clinically significant response to diphencyprone therapy was defined as a cosmetically acceptable response or greater than 75\% terminal hair regrowth. Survival analyses using the Kaplan-Meier method and the Cox proportional hazards model were performed to determine significant factors predictive of regrowth and relapse. RESULTS: Using a survival analysis model, the cumulative patient response at 32 months was 77.9\% (95\% confidence interval, 56.8\%-98.9\%). Variables independently associated with clinically significant regrowth were age at onset of disease and baseline extent of AA. Older age at onset of AA portended a better prognosis. A cosmetically acceptable end point was obtained in 17.4\% of patients with alopecia totalis/universalis, 60.3\% with 75\% to 99\% AA, 88.1\% with 50\% to 74\% AA, and 100\% with 25\% to 49\% AA. A lag of 3 months was present between initiation of therapy and development of significant hair regrowth in the first responders. Relapse after achieving significant regrowth developed in 62.6\% of patients. CONCLUSIONS: Response to diphencyprone treatment in AA is affected by baseline extent of AA and age at disease onset. A prolonged treatment course might be necessary. A predictive model has been developed to assist with patient prognostication and counseling.
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This article was published in Arch Dermatol and referenced in Journal of Clinical & Experimental Dermatology Research

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