{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T17:55:37Z","timestamp":1780336537757,"version":"3.54.1"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,9,6]],"date-time":"2018-09-06T00:00:00Z","timestamp":1536192000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust J Dermatology"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>A range of systemic treatments are used for alopecia areata with variable evidence supporting efficacy. In this systematic review, we evaluated the evidence surrounding systemic treatments for alopecia areata, alopecia totalis and alopecia universalis. A systematic search was conducted of the peer\u2010reviewed literature published between 1946 and March 2018 via Medline, Embase, Amed, the Cochrane Central Register of Controlled Trials, Psych<jats:styled-content style=\"fixed-case\">INFO<\/jats:styled-content> and Lilacs. All randomised controlled trials (<jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s) that evaluated the effectiveness of systemic treatments for individuals with alopecia areata, totalis or universalis were included. Sixteen studies were included with a total of 768 participants. We found eight placebo\u2010controlled <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s, three <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s comparing two systemic treatments and five <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s comparing three treatments. A total of 15 different systemic therapies were investigated. The most frequently investigated therapy was oral prednisolone pulse therapy and oral inosiplex. There was significant variability in the definition of treatment success. No study evaluated the impact of pharmacotherapy on quality of life using complete quantitative quality of life instruments. Adverse events were reported in 13 studies and were corticosteroid related or otherwise well tolerated. Relapse rates were considerable in the four studies that reported this outcome. There is currently no specific systemic therapy that is supported by robust body of evidence from <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s. The current evidence suggests efficacy of oral prednisolone pulse therapy and oral inosiplex. Evidence does not support the use of oral zinc sulphate, alefacept and efalizumab. Future <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s should be adequately powered and employ clearly defined clinical response endpoints to allow future meta\u2010analyses.<\/jats:p>","DOI":"10.1111\/ajd.12913","type":"journal-article","created":{"date-parts":[[2018,9,7]],"date-time":"2018-09-07T05:53:01Z","timestamp":1536299581000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Systemic treatments for alopecia areata: A systematic review"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4530-9864","authenticated-orcid":false,"given":"Vivien Wai Yun","family":"Lai","sequence":"first","affiliation":[{"name":"Monash School of Medicine Faculty of Medicine, Nursing and Health Sciences Monash University Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Chen","sequence":"additional","affiliation":[{"name":"Centre for Health Economics Monash Business School Monash University Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Gin","sequence":"additional","affiliation":[{"name":"Dermatology Alfred Hospital Prahran Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney","family":"Sinclair","sequence":"additional","affiliation":[{"name":"Sinclair Dermatology East Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,6]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.14497"},{"key":"e_1_2_6_3_1","first-page":"397","article-title":"Epidemiology and burden of alopecia areata: a systematic review","volume":"8","author":"Villasante Fricke AC","year":"2015","journal-title":"Clin. 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