Treatment of Alopecia Areata of the Scalp With Intradermal Injections of Botulinum Toxin
|Alopecia Areata||Drug: Intracutaneous injections of Botulinum Toxin A (Botox), 0.1 cc per injection site, which equals 10 units|
|Study Design:||Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Participant, Investigator
Primary Purpose: Treatment
|Official Title:||Treatment of Alopecia Areata of the Scalp With Intradermal Injections of Botulinum Toxin|
- To evaluate hair regrowth with alopecia areata subcutaneous injections of Botulinum toxin A [ Time Frame: Unspecified ]
- Hair regrowth will be assessed after 3 months and 6 months [ Time Frame: Unspecified ]
|Study Start Date:||October 2007|
|Study Completion Date:||October 30, 2009|
|Primary Completion Date:||October 30, 2009 (Final data collection date for primary outcome measure)|
Drug: Intracutaneous injections of Botulinum Toxin A (Botox), 0.1 cc per injection site, which equals 10 units
Hypothesis Intralesional injections of Botulinum Toxin A can be used as a treatment for AA. Potential points of action of this treatment include changes in neurotransmitters, which either directly or via neuroimmunologic mechanisms influence cytocines that are responsible for the hair growth arrest in alopecia areata.
Justification Botulinum Toxin A is an antagonist of Acetylcholine esterase and is used to treat facial wrinkles and hyperhidrosis. One ampoule contains Clostridium Botulinum Toxin Typ A (900kD) 100 E, other components are human albumin and sodium choride. The investigator has learnt about the potential effect of this treatment in AA from personal communication.
Objectives Over a period of 6 month, to assess the therapeutic efficacy and safety of a regimen of two interlesional injections of Botulinum Toxin A at 0 and 3 months, in patients with alopecia areata of the scalp, compared to placebo.
Research Method A total of 20 eligible patients will be enrolled in the study. All patients will receive treatment into one half of their target area and placebo treatment into the other half of their target area.
Measurement of the severity of scalp alopecia areata will be based on the extent terminal scalp hair loss. The Severity of Alopecia Tool (SALT) will be used, which determines the percent of scalp involvement with disease as calculated according to specifications detailed in the Alopecia Areata Investigational Guidelines by Olsen et al..
A circular target area of at least 4 cm diameter will be chosen on the scalp.
At visit 0 and after 3 months at visit 1, the two right quandrants of the target area will each be injected with either Botulinum Toxin A (Botox) at a dose of 10 Units (0.1 cc) or saline 0.9% with a total of 0.1 cc.
The left two quadrants will be injected with the other medication. The patient will not know which half of the target area is injected with the drug or placebo.
The chosen side will be noted in the patient documentation by one investigator. The second investigator who does the efficacy assessment with the qualitative scale will not know which side is treated with Botulinum Toxin A or placebo.
At every visit, extent of the hair loss in the test area will be examined, based on a semi quantitative assessment scale ranging from 0 to 100. The investigator does not know which side had been treated.
There had been unpublished anecdotal reports of the use and the efficacy of Botulinumtoxin A in patients with alopecia areata. No further evidence is available so fare.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00408798
|Canada, British Columbia|
|Department of Dermatology, The Skin Care Centre|
|Vancouver, British Columbia, Canada, V5Z 4E8|
|Principal Investigator:||Jerry Shapiro, MD, FRCPC||University of British Columbia|