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Archives of Dermatological Research

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Open Access 01-03-2024 | Valproate | ORIGINAL PAPER

Topical sodium valproate-loaded nanospanlastics versus conventional topical steroid therapy in alopecia areata: a randomized controlled study

Authors: Rania M. Mogawer, Marwa Mohamed Fawzy, Ahmed Mourad, Heba Ahmed, Maha Nasr, Zeinab Ahmed Nour, Vanessa Hafez

Published in: Archives of Dermatological Research | Issue 2/2024

Abstract

Background

A myriad of therapeutic modalities for alopecia areata are available; however, none is of high level of evidence, creating an immense need for the evaluation of other treatment modalities, of which topical sodium valproate is of potential role via proposed decrease in beta-catenin breakdown, despite its well-known side effect of hair fall as an oral therapy.

Objective

Evaluating the efficacy and the safety of sodium valproate (SV)-loaded nanospanlastics, in comparison to topical corticosteroids, this is the currently available gold standard topical treatment for patchy AA.

Methodology

A total of 66 patients with patchy AA were randomly assigned to receive either topical mometasone furoate lotion or topical SV applied twice daily to all patches except a control patch, which was left untreated. Clinical, trichoscopic and biochemical assessments of beta-catenin tissue levels and Axin-2 gene expression were carried out at baseline and after 3 months.

Results

Both therapeutic modalities were comparable. Potential efficacy was highlighted by significant improvement in the representative patch, the largest treated patch, to the control patch, the smallest untreated patch in both steroid and valproate groups (p = 0.027, 0.003 respectively). Both beta-catenin levels and Axin-2 gene expression were reduced after treatment, pointing to the inhibitory effect of dominating uncontrolled inflammatory milieu. Baseline beta-catenin was found to significantly negatively correlate with improvement in the representative patch in patients with baseline level above 0.42 ng/ml (p = − 0.042).

Conclusion

Both topical SV and steroids are of comparable modest efficacy. Thus, further evaluation of SV is due in combination with intralesional steroids and other anti-inflammatory treatment modalities, together with developing individualized approaches based on baseline beta-catenin level.

ClinicalTrials.gov Identifier

NCT05017454, https://clinicaltrials.gov/ct2/show/NCT05017454.

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Title: Topical sodium valproate-loaded nanospanlastics versus conventional topical steroid therapy in alopecia areata: a randomized controlled study
Authors: Rania M. Mogawer
Marwa Mohamed Fawzy
Ahmed Mourad
Heba Ahmed
Maha Nasr
Zeinab Ahmed Nour
Vanessa Hafez
Publication date: 01-03-2024
Publisher: Springer Berlin Heidelberg
Keywords: Valproate
Alopecia Areata
Published in: Archives of Dermatological Research / Issue 2/2024
Print ISSN: 0340-3696
Electronic ISSN: 1432-069X
DOI: https://doi.org/10.1007/s00403-023-02785-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Topical sodium valproate-loaded nanospanlastics versus conventional topical steroid therapy in alopecia areata: a randomized controlled study

Abstract

Background

Objective

Methodology

Results

Conclusion

ClinicalTrials.gov Identifier

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objective

Methodology

Results

Conclusion

ClinicalTrials.gov Identifier

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