A Randomised Controlled Trial Comparing the Therapeutic Efficacy and Safety of Oral Cyclosporine and Oral Betamethasone Minipulse Therapy in the Treatment of Alopecia Areata.

Background Multiple systemic agents have been evaluated for their efficacy and safety in alopecia areata (AA); however, there is a paucity of comparative studies available in literature. Objective To compare the efficacy and safety of oral cyclosporine and betamethasone mini-pulse therapy in the treatment of alopecia areata (AA). Materials and methods This non-blinded, randomized, parallel-group controlled trial included 60 patients. Group A (n=30) received oral cyclosporine 3 mg/kg body weight, and Group B (n=30) received oral betamethasone mini-pulse therapy in a dose of 0.1mg/kg body weight on two consecutive days per week for 12 weeks each. Results In the cyclosporine group, 53.3% of the patients responded to the treatment as compared to 33.3% of the patients in the betamethasone mini-pulse therapy group. In the cyclosporine group, patients with severe AA were found to respond better to the treatment. Based on the patient self-assessments, 73.3% of patients in the cyclosporine group and 43.3% of patients in the betamethasone mini-pulse group rated their hair regrowth as excellent or good. Adverse effects to the therapy were noted in 76.6% of patients in the cyclosporine group, whereas it was 53.3% in the betamethasone minipulse group. All of them were mild and reversible in nature. Conclusion Oral cyclosporine therapy appeared to be superior to betamethasone mini-pulse therapy in terms of therapeutic efficacy.