Efficacy of Clinical and Pathogenetic Treatment of Patients with Alopecia Areata Associated with Metabolic Syndrome

Abstract

Alopecia areata (HA) is an autoimmune inflammatory disease of hair follicles (HF) with a nonscarring pattern of hair loss on a scalp and/or other areas of skin. The objective: to assess the efficacy of the developed complex pathogenetically justified method of treatment of patients with AA associated with MS using drugs for the correction of dyslipidaemia and insulin resistance. Materials and methods. 59 patients with alopecia areata of moderate severity associated with metabolic syndrome underwent complex pathogenetic treatment with correction of lipid and carbohydrate indicators. In the course of the study, patients were divided into 4 groups: 1A (n=16) – patients with AA, burdened with MS (3 components), who underwent basic therapy of AA and treatment of metabolic disorders with rosuvastatin at a dose of 10 mg per day; 1B (n=14) – patients with AA with MS (3 components), who were prescribed basic therapy and correction of metabolic disorders through diet; 1C (n=14) – patients with AA with MS (4–5 components), who received basic therapy, as well as rosuvastatin 10 mg per day and thioctacid 600 mg per day; 1D (n=15) – patients with AA, burdened with MS (4–5 components), who received basic therapy and followed a diet. Results. As a result of the study, the following predicted patterns were revealed: - the level of blood glucose in patients of group 1A after 6 months of treatment decreased by 5%, in patients of group ǀB – by 2%; in group 1A, the acceleration of the improvement dynamics of the HOMA index and triglycerides was determined, in contrast to group ǀB; the level of total cholesterol in group 1A compared to group ǀB was statistically significantly lower (p<0.05%); - statistically significant differences (p<0.05%) were found regarding the improvement of blood glucose and LDL levels after 6 months of treatment in patients of groups 1C and 1D in favour of group 1C, taking into account the improvement of these indicators in both groups during the study period; - compared to patients of group 1D, patients of group 1C after 6 months of treatment showed a statistically significant improvement in all the studied indicators that determine the severity of MS; - after 6 months of treatment of patients with AA, statistically more cases of recovery were found in group 1C compared to group 1A (p=0.041); after 12 months in group 1C, the frequency of cases of clinical recovery was statistically significantly higher (p=0.069) compared to group 1D (p=0.035) and group 1B (p=0.017); - the number of cases of a diagnosed positive effect (clinical recovery and partial effect), which began to manifest itself after 6 months and intensified after 12 months, prevailed in group 1A in contrast to group 1B, in which, on the contrary, an increase in the number of cases with no effect or deterioration was recorded; - the number of cases of a positive effect in group 1C after 6 months of dermatosis treatment statistically significantly exceeded the number of such cases in group 1D, and after 12 months of treatment this trend remained; - the calculation of the average annual growth rate of patients who were diagnosed with a positive effect during the study period in groups 1A and 1C revealed a higher growth rate compared to groups 1B and 1D: in group 1A it was on average 2.62% in contrast to group 1B, where it was half as much – 1.29%; in group 1C it was 2.21%, which was twice as high as that of the group 1D (1.12%). Conclusions. A pathogenetically substantiated method of treating patients with AA associated with MS, which consists of the complex use of drugs for the correction of dyslipidaemia and insulin resistance and basic therapy of AA has been developed. A positive effect was obtained on the implemented complex treatment.