Abstract Number: 196

Steroid-sparing agents for alopecia areata: a retrospective review of 150 patients

V. Lai1, R. Sinclair2

Meeting: 2021 Dermcoll

Session Information

Date: -

Session Title: Poster Presentations

Session Time: -

Introduction: Alopecia areata (AA) is a T-cell mediated autoimmune disease of the hair follicle. Current manage- ment options include intralesional and systemic corticos- teroids, with steroid-sparing agents used to reduce long- term steroid side effects. The success rates of steroid-spar- ing second-line agents are poorly investigated and there are few published randomised placebo-controlled trials.

Objective: A retrospective analysis of 150 AA patients who used steroid-sparing agents at a single, large Melbourne clinic was performed to evaluate the efficacy of these agents, measured through a continuation of the agent at 6 months.

Materials and Methods: Patients who had a diagnosis of AA, alopecia totalis and alopecia universalis and who had used azathioprine, cyclosporine, methotrexate or sul- fasalazine were included. Electronic medical records were scanned to record patients, systemic agents, dose, concur- rent prednisolone use and duration of treatment. ‘Respon- ders’ were defined as patients who either continued to take medication for 6 months or longer or who stopped medication earlier due to complete remission of disease.

Results: The response rate of azathioprine (n = 73), methotrexate (n = 22), cyclosporine (n = 43) at 6 months respectively was 80.82%, 72.73%, 76.74%. The proportion (average dose, mg) of responders on concurrent prednisolone for azathioprine, methotrexate and cyclosporine respectively was 63.01% (7.42 mg), 45.45% (4.25 mg), 58.14% (4.55 mg).

Conclusions: There are high response rates at 6 months for patients using azathioprine, methotrexate and cyclos- porine. Continuation rates are highest in azathioprine, which may reflect a difference in the adverse event pro- files between the agents. Prednisolone used concurrently likely contributes to the response.