Comparative study between the efficacies of azathioprine and mesalazine in the treatment of severe alopecia areata.

Background: Various systemic agents have been assessed for treatment of alopecia areata; however, there is a paucity of comparative studies. Aim: To compare the efficacy of azathioprine versus mesalazine in the treatment of severe alopecia areata. Methods: Our study was carried out in 30 patients with severe alopecia areata divided into two groups, group A: fifteen patients were treated by azathioprine in an oral dose of 1–2 mg/kg/day and group B: fifteen patients were treated by mesalazine in an oral dose of 15–30 mg/kg/day in two divided doses. The treatment was considered effective if percentage regrowth of hair was determined by change in SALT score >50 from base line after 6 months of treatment. The treatment was continued for 3–6 months after complete remission to minimize the risk of relapse. The dose was gradually tapered during this time. Results: The study found that there is statistically significant difference between mean SALT scores before treatment and after 6 months of treatment in both groups. In group A, SALT score at base line was 84.42 ± 17.41, after 6 months it was 35.95 ± 35.79 (p value 0.04). In group B, SALT score at base line was 73.06 ± 22.10, after 6 months it was 23.04± 12.27 (p value 0.037). Changes in SALT score after 6 months were −27.74 ± 20.66 in group A and −60.42±38.41 in group B (p value 0.055). Conclusion: Mesalazine may be considered as effective as azathioprine with lesser side effects. Azathioprine is also considered safe. However, a large group study should be performed to confirm these findings. [ABSTRACT FROM AUTHOR]