Alopecia areata: cyclosporin fails to show significant benefit

  • J Am Acad Dermatol

  • Brian Richardson, PhD
  • Clinical Essentials
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Takeaway

  • Cyclosporin (Sandimmune, Restasis, Gengraf) was associated with a numerically higher but nonstatistically significant improvement in Severity of Alopecia Tool (SALT) score compared with placebo in a randomized controlled trial of 32 patients with moderate-to-severe alopecia areata.

Why this matters

  • Steroid-sparing agents such as cyclosporin are often used for treatment of alopecia areata, despite a lack of clinical trials evaluating efficacy.

Key results

  • Cyclosporin was associated with numerically greater rates of ≥50% reduction in SALT score (31.3% vs 6.3%; P=.07) and ≥1 grade improvement in eyelash assessment scale (18.8% vs 0.0%; P=.07).
  • Cyclosporin was associated with a significantly greater rate of ≥1 grade improvement in eyebrow assessment scale (31.3% vs 0.0%; P=.02) compared with placebo.
  • Cyclosporin and placebo were associated with similar adverse event rates (83% for both; P=1.00).

Study design

  • 32 patients with moderate-to-severe alopecia areata, 16 treated with cyclosporin for 3 months and 16 with placebo, were analyzed for efficacy outcomes.
  • Funding: Australia Alopecia Areata Foundation.

Limitations

  • Small patient sample size.