Faculty Bibliography

Antiandrogens have demonstrated a protective effect for COVOD-19 patients in observational and interventional studies. The goal of this study was to determine if proxalutamide, an androgen receptor antagonist, could be an effective treatment for men with COVID-19 in an outpatient setting. A randomized, double-blinded, placebo-controlled clinical trial was conducted at two outpatient centers (Brasilia, Brazil). Patients were recruited from October 21 to December 24, 2020 (clinicaltrials.gov number, NCT04446429). Male patients with confirmed COVID-19 but not requiring hospitalization (COVID-19 8-point ordinal scale <3) were administered proxalutamide 200 mg/day or placebo for up to 7 days. The primary endpoint was hospitalization rate at 30 days post-randomization. A total of 268 men were randomized in a 1:1 ratio. 134 patients receiving proxalutamide and 134 receiving placebo were included in the intention-to-treat analysis. The 30-day hospitalization rate was 2.2% in men taking proxalutamide compared to 26% in placebo, P < 0.001. The 30-day hospitalization risk ratio was 0.09; 95% confidence interval (CI) 0.03-0.27. Patients in the proxalutamide arm more frequently reported gastrointestinal adverse events, however, no patient discontinued treatment. In placebo group, 6 patients were lost during follow-up, and 2 patients died from acute respiratory distress syndrome. Here we demonstrate the hospitalization rate in proxalutamide treated men was reduced by 91% compared to usual care.

Topical minoxidil has been used as a topical treatment for androgenetic alopecia (AGA) for more than 30 years. Approximately 60 to 70% of patients do not achieve hair growth. Minoxidil is a pro-drug. In order to exert biological activity, minoxidil requires conversion to minoxidil sulfate by sulfotransferase enzymes (SULT1A1). We have reported extensively that SULT1A1 activity in the outer root sheath (ORS) of the hair follicle correlates directly with topical minoxidil response. We have demonstrated the clinical utility and validity of a colorimetric test to measure the follicular SULT1A1 activity in plucked hair as a method to predict minoxidil responders. This same test also predicts clinical response to oral minoxidil.

Alopecia areata (AA) is a common autoimmune skin disease resulting in the loss of hair on the scalp and elsewhere on the body that affects over 146 million people worldwide at some point in their lives. Founded in 1981, the National AA Foundation (NAAF) is a nonprofit organization that supports research to find a cure or acceptable treatment for AA, supports those with the disease, and educates the public about AA. NAAF conducts research summits every two years to review progress and create new directions in its funded and promoted research. This report from the seventh AA Research Summit, Forging the Future, held December 4-5, 2018 in New York City provides highlights of the research presented and future research priorities identified during targeted discussion sessions.

BACKGROUND:Platelet-rich plasma (PRP) shows promise as an androgenetic alopecia (AGA) treatment. OBJECTIVE:Conduct a randomized placebo-controlled split-scalp study to investigate PRP's effects on hair regrowth and thickness. METHODS:35 study participants with AGA had two 7.6-centimeter x 7.6-centimeter squares tattooed on their scalps. Areas were randomly assigned to intradermal injection with PRP or saline. Subjects underwent three monthly treatment sessions with evaluation three months after final treatment. RESULTS:(p < 0.05). There was no significant difference in hair density change between the two groups (p > 0.05). No serious adverse events were reported. LIMITATIONS/CONCLUSIONS:Possible PRP diffusion due to split-scalp study design as well as microinjections causing micro-injury to both sides. CONCLUSION/CONCLUSIONS:PRP may have benefit in increasing hair density.