Rodney Daniel Sinclair

University of Melbourne | MSD · Department of Medicine

Abbreviations: AP, alkaline phosphatase; DP, dermal papilla; DPC, dermal papilla cell; LiCl, lithium chloride

Hair follicle miniaturization is the hallmark of male pattern hair loss (MPHL), female pattern hair loss (FPHL), and alopecia areata (AA). AA has the potential for complete hair regrowth and reversal of miniaturization. MPHL and FPHL are either irreversible or show only partial regrowth and minimal reversal of miniaturization. Hypothesis: The arrec...

A series of four cases of severe recalcitrant hidradenitis suppurativa treated with infliximab is presented. All patients had failed to respond to prior medical and surgical management. Baseline Quantiferon-TB Gold and chest radiograph were carried out before commencement of treatment. No patients had associated Crohn's disease. All patients receiv...

The comparative effects of biological response modifiers (BRMs) on the severity of psoriasis and its effects on health-related quality of life (HRQoL) have not been evaluated. To conduct a meta-analysis to assess the effects of available biological agents on the severity of psoriasis, as well as to provide data on the effects of these agents on HRQ...

Introduction: Previous data on baricitinib treatment in severe alopecia areata (AA) has shown that treatment response varies by baseline disease severity and by duration of current episode. In general, hair regrowth response varies, and clinicians lack data on how long to optimally treat patients to achieve response. In the literature, time to onse...

Female androgenetic alopecia (FAGA) affects approximately half of women during their lifetime and can have significant psychological impact. Despite its prevalence, treatment options have traditionally been limited. In this study, we examined the current prescribing patterns of Australian dermatologists for FAGA ( n = 54), including the use of spir...

Importance The results of small studies suggest that off-label use of low-dose oral minoxidil (LDOM) may be safe and effective for patients with hair loss, but larger trials and standardized guidelines are lacking. Objective To create an expert consensus statement for LDOM prescribing for patients with hair loss. Evidence Review The current liter...

Introduction. Elevations in total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) can occur with baricitinib treatment, consistent with a class effect of JAK inhibitors. In this analysis, we characterized changes in lipid levels and use of lipid-lowering medication among patients with sever...

The ALLEGRO phase 2b/3 study investigated the efficacy and safety of ritlecitinib in patients with alopecia areata (AA). To describe the impact of ritlecitinib on patient-reported hair loss using the Alopecia Areata Patient Priority Outcomes (AAPPO) instrument and evaluate the relationship between clinically meaningful hair regrowth and improvement...

This post‐hoc analysis of the ALLEGRO phase 2b/3 study (NCT03732807) evaluated the efficacy and safety of ritlecitinib, an oral Janus kinase 3/TEC family kinase inhibitor, in patients with alopecia totalis (AT) and alopecia universalis (AU). Patients aged ≥ 12 years with alopecia areata (AA) and ≥50% scalp hair loss received once‐daily ritlecitinib...

Clinician-reported outcome measures (ClinROMs) are an important part of disease assessment in daily practice and clinical trials. There is a broad disagreement on the most appropriate ClinROM for a comprehensive assessment of alopecia areata (AA) severity. This paper aims to identify the currently available ClinROMs for AA through a systematic lite...

Frontal fibrosing alopecia (FFA) is a primary cicatricial alopecia characterized by hairline recession, pruritus, and facial papules (FP). Various therapies are used to stabilize disease activity and induce remission. However, FP of FFA is resistant to treatment in many cases. In this review, we searched the PubMed and Google Scholar databases to s...

Introduction: Patients with alopecia areata (AA) report high levels of dissatisfaction with commonly used treatments. Patient-reported outcomes are essential to understanding patients' experiences with AA treatments. The objective of this study was to evaluate patient-reported satisfaction with hair growth among patients with AA receiving ritlecit...

Introduction To understand the experiences of adolescent and adult patients living with alopecia areata (AA) in Australia regarding symptom severity and the impact on psychosocial well‐being and work/classroom productivity. Materials and Methods A cross‐sectional online patient survey among adolescent and adult patients diagnosed with AA was recru...

Background Efficacy of the Janus kinase (JAK) inhibitor baricitinib for severe alopecia areata (AA) continuously increased over 52 weeks in two Phase 3 trials. There are limited long‐term data on JAK inhibitors in AA. Objectives To evaluate efficacy and safety of baricitinib for severe AA through 104 weeks of continuous therapy. Methods Integrate...

Importance Current measures of alopecia areata (AA) severity, such as the Severity of Alopecia Tool score, do not adequately capture overall disease impact. Objective To explore factors associated with AA severity beyond scalp hair loss, and to support the development of the Alopecia Areata Severity and Morbidity Index (ASAMI). Evidence Review A...

Baricitinib is a Janus kinase inhibitor which is now FDA approved for the treatment of severe alopecia areata (AA) in adults. However, the clinical trials which demonstrated the efficacy of baricitinib in the treatment of severe AA did not include men aged >60 years and women aged >70 years. We retrospectively assessed the efficacy and safety of ba...

The ALLEGRO phase 2a and 2b/3 studies demonstrated that ritlecitinib, an oral JAK3/TEC family kinase inhibitor, is efficacious at doses of ≥ 30 mg in patients aged ≥ 12 years with alopecia areata (AA). The objective of this study was to evaluate the safety of ritlecitinib in an integrated analysis of four studies in AA. Two cohorts were analyzed: a...

Background The Severity of Alopecia Tool (SALT) is a standardized method for quantifying scalp hair loss in alopecia areata (AA). SALT scores can be used to guide treatment decisions and are widely used as eligibility criteria and endpoints for clinical trials in AA. However, clinicians may be unfamiliar with assessing and envisioning SALT scores i...

The present analyses report integrated results from BRAVE-AA1 (NCT03570749) and BRAVE-AA2 (NCT03899259) on the clinical benefits of baricitinib treatment on the basis of the amount of scalp hair regrowth through 52 weeks of treatment. This post hoc analysis was conducted with data from patients who were treated continuously for 52 weeks with barici...

Background: Baricitinib is approved for the treatment of adults with severe alopecia areata (AA). In the absence of robust data on the patterns of regrowth during treatment of severe AA, there is a gap in the knowledge regarding treatment expectations. Objectives: To examine whether different clinical response subgroups could be identified in ba...

What is this summary about?: This is a summary of the results of the ALLEGRO phase 2b/3 clinical trial, originally published in The Lancet. ALLEGRO-2b/3 looked at how well and safely the study medicine, ritlecitinib, works in treating people with alopecia areata ('AA' for short). The immune system protects your body from outside invaders such as b...

Patient viewpoint I had no idea what was wrong with me and found it really difficult to cope with it [alopecia areata, AA]. My hair loss was gradual (beard spots initially) but then it really progressed rapidly to a complete loss of all my hair. The hardest part, I stayed away from friends/events as it would really break me when I saw the look on p...

Androgenetic alopecia (AGA) is highly prevalent among Australian men and can have significant psychological impacts. Despite its prevalence, treatment options have traditionally been limited. In this study, we examined the current prescribing patterns of Australian dermatologists for male AGA.

Background: Whilst there are several recognised explanations for persistent telogen-phase hair loss, for a proportion of cases, no clear underlying cause can be identified. These cases have been given the diagnostic label chronic telogen effluvium: a poorly characterised condition where there is legitimate uncertainty as to whether it represents a...

Background: Alopecia areata is characterised by non-scarring loss of scalp, face, or body hair. We investigated the efficacy and safety of ritlecitinib, an oral, selective dual JAK3/TEC family kinase inhibitor, in patients with alopecia areata. Methods: In this randomised, double-blind, multicentre, phase 2b-3 trial done at 118 sites in 18 count...

Introduction: Hirsutism is the presence of excessive body hair in a male pattern distribution in a woman and can affect up to 20% of women. It can be associated with high levels of psychosocial and psychosexual morbidity. It is a common cause for presentation to medical staff particularly endocrinologists, gynaecologists and dermatologists. Areas...

Background: The oral Janus kinase (JAK) inhibitor baricitinib has demonstrated efficacy for severe alopecia areata (AA) over 36 weeks. There are limited data on the longer-term treatment of AA. Objective: The aim of this study was to evaluate the efficacy and safety of baricitinib for AA in adults with ≥50% scalp hair loss through 52 weeks of co...

Alopecia areata (AA) impacts on health-related quality of life (HRQoL). The Women’s Androgenetic Alopecia Quality of Life (WAA-QoL) is a reliable, validated HRQoL measure in female patients with androgenetic alopecia (AGA). There is no equivalent measure for females with AA. Data were collected as part of GRASS Australia. The WAA-QoL, DLQI, and Ski...

Alopecia areata (AA) ist eine autoimmune, nicht vernarbende Alopezie mit unterschiedlichen klinischen Mustern, am häufigsten eine fleckenhaft auftretende Veränderung. Wir berichten über einen Fall von AA mit ungewöhnlicher Beteiligung des frontalen Haaransatzes, ähnlich der frontalen fibrosierenden Alopezie (FFA), einer Form der vernarbenden Alopez...

Ritlecitinib, an oral JAK3/TEC inhibitor, inhibits cytokines IL-15 and IFN-γ that play a critical role in vitiligo pathogenesis. In a phase 2b trial, ritlecitinib demonstrated a significant improvement on the centrally read Facial Vitiligo Area Scoring Index (crF-VASI) at Week 24 in patients with active nonsegmental vitiligo (NSV) at 50 mg daily wi...

Use of theJAK-1 inhibitor clinical trial agent filgotinib results in resolution of severe alopecia areata in a patient with Crohn’s disease following cross-specialty collaboration.

Background Baricitinib, an oral, selective, reversible Janus kinase (JAK)1/JAK2 inhibitor, is an approved treatment for adults with severe alopecia areata (AA) in the USA, European Union and Japan. Objectives To report safety data for baricitinib in patients with severe AA from two clinical trials including long-term extension periods. Methods Th...

Background Vitiligo is a chronic autoimmune disorder characterized by depigmented patches of the skin. Objective To evaluate the efficacy and safety of ritlecitinib, an oral JAK3/TEC inhibitor, in patients with active nonsegmental vitiligo (NSV) in a phase 2b trial (NCT03715829). Methods Patients were randomized to once-daily oral ritlecitinib ±...

Background The 24-week, double-blind period of the ALLEGRO Phase 2a trial (NCT02974868) evaluated the safety and efficacy of ritlecitinib (JAK3/TEC inhibitor) and brepocitinib (TYK2/JAK1 inhibitor) in patients with alopecia areata; patients could subsequently continue treatment in a 24-week single-blind extension (SBE) followed by a cross-over open...

Minoxidil solution is used for the treatment of androgenic alopecia. While the 5% minoxidil solution has superior efficacy to the 2% solution, it is unknown whether concentrations of minoxidil higher than 5% provide additional clinical benefit. We performed a review of the literature to examine the evidence on the efficacy and safety of higher conc...

Introduction: Precise evaluation of changes in hair count is crucial for monitoring progression of hair loss and the effects of treatment. The focus of this study is the comparison of the various examination and assessment techniques in terms of the precision of hair count change observed in trichoscopy images. Methods: Controlled hair extractio...

Background: Alopecia areata is an autoimmune condition characterized by rapid hair loss in the scalp, eyebrows, and eyelashes, for which treatments are limited. Baricitinib, an oral, selective, reversible inhibitor of Janus kinases 1 and 2, may interrupt cytokine signaling implicated in the pathogenesis of alopecia areata. Methods: We conducted...

Hair is a deeply rooted component of identity and culture. Recent articles in this series have focused on scientific evidence relating to hair growth and new insights into the pathogenesis and mechanism of hair loss. This article reviews emerging evidence that has advanced our understanding of hair growth in both of these areas to provide a context...

Introduction Alopecia areata (AA) is an inflammatory and autoimmune form of hair loss which can present with one patch of hair loss, but in more extreme cases can lead to total bodily hair loss. There are limited therapeutic options and no cure, but medication can sometimes induce sustained remission. Disease control cannot be guaranteed; even thos...

Atopic dermatitis (AD, also called atopic eczema) is a long-term skin disease that causes intensely itchy, red skin. Healthcare providers can prescribe medicated creams and ointments to reduce the signs and symptoms of AD. However, these treatments are not always enough to provide relief. A new medicine called abrocitinib, which is taken every day...

Background Fibrosing alopecia in a pattern distribution (FAPD) is a primary cicatricial alopecia considered a subtype of lichen planopilaris (LPP). Objective The clinical and histopathological features, and treatment response of 24 female patients with FAPD were evaluated. Methods Demographic, clinical, histopathological and treatment data of pat...

Background Cutaneous manifestations of COVID-19 may be useful disease markers and prognostic indicators. Recently, post-infectious telogen effluvium and trichodynia have also been reported. Objective To evaluate the presence of trichodynia and telogen effluvium in patients with COVID-19 and describe their characteristics in relation to other signs...

Antiandrogens have demonstrated a protective effect for COVOD-19 patients in observational and interventional studies. The goal of this study was to determine if proxalutamide, an androgen receptor antagonist, could be an effective treatment for men with COVID-19 in an outpatient setting. A randomized, double-blinded, placebo-controlled clinical tr...

Background Frontal fibrosing alopecia (FFA) has become one of the most common causes of cicatricial alopecia worldwide, but lacks clear aetiology and robust clinical trial evidence for efficacy and safety of agents currently used for treatment. Objectives To enable data to be collected worldwide on FFA using common criteria and assessment methods....

Tofacitinib is a JAK1/3 inhibitor used off‐label to treat alopecia areata (AA). Oral tofacitinib undergoes extensive hepatic metabolism and has numerous drug interactions and a half‐life of 3 hours necessitating twice daily dosing. Sublingual delivery bypasses hepatic first‐pass metabolism, which may provide pharmacokinetic benefits and reduce gast...

During the COVID-19 pandemic, rapid, real-world evidence is essential for the development of knowledge and subsequent public health response. In dermatology, provider-facing and patient-facing registries focused on COVID-19 have been important sources of research and new information aimed at guiding optimal patient care. The 7 dermatology registrie...

High-quality dermatology patient registries often require considerable time to develop and produce meaningful data. Development time is influenced by registry complexity and regulatory hurdles that vary significantly nationally and institutionally. The rapid emergence of the COVID-19 global pandemic has challenged health services in an unprecedente...

Background The oral Janus kinase 1 (JAK1) inhibitor abrocitinib, which reduces interleukin-4 and interleukin-13 signaling, is being investigated for the treatment of atopic dermatitis. Data from trials comparing JAK1 inhibitors with monoclonal antibodies, such as dupilumab, that block interleukin-4 receptors are limited. Methods In a phase 3, doub...

Importance: A recent expert consensus exercise emphasized the importance of developing a global network of patient registries for alopecia areata to redress the paucity of comparable, real-world data regarding the effectiveness and safety of existing and emerging therapies for alopecia areata. Objective: To generate core domains and domain items...