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

## TL;DR

This study compared two treatments for alopecia areata and found that oral cyclosporine was more effective but had more side effects than betamethasone mini-pulse therapy.

## Contribution

The study provides a direct comparison of cyclosporine and betamethasone mini-pulse therapy for alopecia areata in a randomized controlled trial.

## Key findings

- Cyclosporine had a higher response rate (53.3%) compared to betamethasone (33.3%).
- Patients with severe alopecia areata responded better to cyclosporine.
- Cyclosporine had more adverse effects (76.6%) than betamethasone (53.3%), but all were mild and reversible.

## Abstract

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.