Open AccessComparative Efficacy and Adverse Clinical Events of Methotrexate versus Azathioprine with Steroid Mini Pulse Therapy in the Management of Moderate to Severe Alopecia Areata: A Tertiary Centre Based Interventional Study
Author(s) -
Aditi Mishra,
Shekhar Kc,
Elisha Shrestha,
Chandranshu Pandey,
D Karn
Publication year - 2022
Publication title -
nepal journal of dermatology, venereology and leprology
Language(s) - English
Resource type - Journals
eISSN - 2091-167X
pISSN - 2091-0231
DOI - 10.3126/njdvl.v20i1.42453
Subject(s) - alopecia areata , medicine , adverse effect , azathioprine , hair loss , methotrexate , scalp , dermatology , prednisone , disease
Alopecia areata is a T cell-mediated autoimmune disorder of hair follicles resulting in partial or total hair loss. Treatment of alopecia areata is difficult, and it has variable severity.Objectives: To compare the clinical efficacy and adverse clinical events of azathioprine versus methotrexate with steroid minipulse therapy in managing moderate to severe alopecia areata.Materials and Methods: Prospective non-blinded clinical trial conducted for 6 months in Department of Dermatology at Dhulikhel Hospital. Dermoscopic evidence of alopecia areata patients treated according to group assigned and effects and adverse event were noted.Results: There was a total of 36 patients enrolled. Twenty patients were in Group A (AZT+MPT) and 16 in group B (MTX+MPT). There was a significant improvement in SALT score at 6 months (Group A p-value: 0.03; group B p-value: 0.001). Treatment efficacy (percent scalp hair regrowth) in group A was 79.2%, and in group B was 89.01%.Conclusion: Both treatment regimens showed marked improvement with SALT score reduction; however, methotrexate with steroid minipulse therapy showed slightly higher treatment efficacy than azathioprine with steroid minipulse therapy.