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

Abstract

DOI: 10.52705/2788-6190-2023-03-14
УДК:616.594.14-031.84-031.37.72-02:[616.379-008.64-036.4:616-056.52:616.153.915/.922]-036.1-092

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 the 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 the 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 in 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 treatement.