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Cyclosporin ‘moderately effective’ at inducing remission of alopecia areata

Adults with moderate to severe alopecia areata treated with cyclosporin had a greater reduction in Severity of Alopecia Tool score over time when compared with a placebo group, according to a study.

In the double-blind, placebo-controlled trial, 36 adults were randomly assigned in a 1:1 ratio to cyclosporin (4 mg/kg per day) or placebo for 3 months.

Participant visits included physical examination with assessment of vital signs, blood chemistry with full blood examination, urine pregnancy test for women, recording adverse events and concomitant medications.

Efficacy was defined using the Severity of Alopecia Tool (SALT).

Mean age of the patients was 41 years, and participants were predominantly women (80.6%).

At baseline, the mean percentage of scalp hair loss at baseline was 79.4% via SALT score, and about 50% of the participants had no eyelashes or eyebrows at baseline.

Nearly one-third of participants (31.3%) in the cyclosporin group achieved at least a 50% reduction in SALT score at the end of 3 months compared with 6.3% of participants on placebo.

The response rate approached but did not reach statistical significance, most likely due to sample size and treatment length, according to the researchers.

One participant (6.3%) achieved SALT100 at 3 months, but none achieved the benchmark in the placebo group.

Researchers found no significant difference in adverse events between treatment groups.

“This study suggests that 4 mg/kg/day cyclosporin monotherapy for 3 months is moderately effective at inducing remission of [alopecia areata]. Combination of cyclosporin with glucocorticosteroids may further increase response rates,” Gang Chen, PhD, an associate professor at the Centre for Health Economics at Monash University in Clayton, Victoria, Australia, and colleagues wrote. – by Abigail Sutton

Disclosures: The authors report no relevant financial disclosures.