A Comparative 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

Authors

  • Aditi Mishra Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal https://orcid.org/0000-0002-1758-2153
  • Shekhar KC Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal
  • Elisha Shrestha Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal https://orcid.org/0000-0003-1337-7977
  • Chandranshu Pandey Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal
  • Dharmendra Karn Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal

DOI:

https://doi.org/10.3126/njdvl.v20i1.42453

Keywords:

Alopecia areata, Azathioprine, Methotrexate

Abstract

Introduction: 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.

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Author Biographies

Aditi Mishra, Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal

Lecturer, Department of Dermatology

Shekhar KC, Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal

Assistant Professor, Department of Dermatology

Elisha Shrestha, Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal

Medical instructor

Chandranshu Pandey, Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal

Medical Officer, Department of Dermatology

Dharmendra Karn, Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal

Professsor, Department of Dermatology

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Published

2022-03-29

How to Cite

Mishra, A., KC, S., Shrestha, E., Pandey, C., & Karn, D. (2022). A Comparative 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. Nepal Journal of Dermatology, Venereology &Amp; Leprology, 20(1), 29–33. https://doi.org/10.3126/njdvl.v20i1.42453

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Original Articles