Medicine (St Vincent's) - Research Publications

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    Effect of gender-affirming hormone therapy on hair growth: a systematic review of the literature
    Tang, GT ; Zwickl, S ; Sinclair, R ; Zajac, JD ; Cheung, AS (OXFORD UNIV PRESS, 2023-09-19)
    Gender-affirming hormone therapy (GAHT) leads to changes in body composition, secondary sex characteristics and in the distribution and pattern of hair growth. Transgender individuals undergoing GAHT may experience altered hair growth patterns that may be affirming and desirable, or undesirable with a subsequent impact on their quality of life. Given increasing numbers of transgender individuals commencing GAHT worldwide and the clinical relevance of the impact of GAHT on hair growth, we systematically reviewed the existing literature on the impact of GAHT on hair changes and androgenic alopecia (AGA). The majority of studies used grading schemes or subjective measures of hair changes based on patient or investigator's examination. Very few studies used objective quantitative measures of hair parameters but demonstrated statistically significant changes in hair growth length, diameter and density. Feminizing GAHT with estradiol and/or antiandrogens in transgender women may reduce facial and body hair growth and also can improve AGA. Masculinizing GAHT with testosterone in transgender men may increase facial and body hair growth as well as induce or accelerate AGA. The impact of GAHT on hair growth may not align with a transgender person's hair growth goals and specific treatment for AGA and/or hirsutism may be sought. Further research on how GAHT affects hair growth is required.
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    Clinical features and treatment outcomes of frontal fibrosing alopecia in men
    Moussa, A ; Bennett, M ; Bhoyrul, B ; Kazmi, A ; Asfour, L ; Sinclair, RD (WILEY, 2022-06-21)
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    Concurrent chronic alopecia areata and severe atopic dermatitis successfully treated with upadacitinib
    Asfour, L ; Getsos Colla, T ; Moussa, A ; Sinclair, RD (WILEY, 2022-06-20)
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    Phase 2 BELIEVE study part B: Efficacy and safety of rilzabrutinib for patients with pemphigus vulgaris
    Murrell, DF ; Patsatsi, A ; Stavropoulos, P ; Baum, S ; Zeeli, T ; Kern, JS ; Sinclair, R ; Neale, A ; Arora, P ; Sugerman, PB ; Shi, G ; Werth, VP ; Caux, F ; Joly, P (WILEY, 2022-06-27)
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    Treatment of generalized granuloma annulare with tildrakizumab
    Awad, A ; Nirenberg, A ; Sinclair, R (WILEY, 2022-05-02)
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    Treatment of dissecting cellulitis of the scalp with Tildrakizumab
    Awad, A ; Sinclair, R (WILEY, 2022-05-04)
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    Successful treatment of chronic severe alopecia areata with abrocitinib
    Bennett, M ; Moussa, A ; Sinclair, R (WILEY, 2022-04-07)
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    Effective treatment of oral lichen planus with the JAK inhibitor baricitinib
    Moussa, A ; Colla, T ; Morrison, B ; Sinclair, R (WILEY, 2022-02-25)
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    Successful treatment of folliculitis decalvans with baricitinib: A case series
    Moussa, A ; Asfour, L ; Eisman, S ; Bhoyrul, B ; Sinclair, R (WILEY, 2022-01-22)
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    Safety and Efficacy of Ritlecitinib and Brepocitinib in Alopecia Areata: Results from the Crossover Open-Label Extension of the ALLEGRO Phase 2a Trial.
    King, B ; Guttman-Yassky, E ; Peeva, E ; Banerjee, A ; Zhu, L ; Zhu, H ; Cox, LA ; Vincent, MS ; Sinclair, R (Elsevier BV, 2022-11)
    The 24-week, double-blind period of the ALLEGRO phase 2a trial (NCT02974868) evaluated the safety and efficacy of ritlecitinib (Jak3/tyrosine kinase expressed in the hepatocellular carcinoma inhibitor) and brepocitinib (tyrosine kinase 2/Jak1 inhibitor) in patients with alopecia areata; patients could subsequently continue treatment in a 24-week single-blind extension, followed by a crossover open-label extension, described in this article. Patients who did not achieve ≥30% improvement from baseline in Severity of Alopecia Tool score at the end of the single-blind extension entered a 24-week crossover open-label extension: the ritlecitinib group switched to brepocitinib, and the brepocitinib group switched to ritlecitinib. Eighteen patients switched to brepocitinib, and five switched to ritlecitinib. Six treatment-emergent adverse events were reported by five patients; no new safety risks were observed after crossover. An exploratory efficacy evaluation showed that none of the five patients receiving ritlecitinib in the crossover open-label extension achieved ≥30% improvement from baseline in Severity of Alopecia Tool score or improvement in eyebrow/eyelash assessments. Four of 16 patients receiving brepocitinib achieved ≥30% improvement from baseline in Severity of Alopecia Tool score or better; 4 of 15 and 5 of 12 showed improvement in eyebrow and eyelash assessments, respectively. Although the small number of patients precludes firm conclusions regarding efficacy, the data suggest that some patients with alopecia areata and inadequate response to ritlecitinib after ≥24 weeks show benefit after switching to brepocitinib.