Treatment of Severe Alopecia Areata: Combination Therapy Using Systemic Cyclosporine A with Low Dose Corticosteroids.
BACKGROUND
Combination therapy using cyclosporine A (CsA) together with low-dose corticosteroids has adequate efficacy with little toxicity for the treatment of severe alopecia areata (AA).


OBJECTIVE
We wanted to evaluate the clinical efficacy of combination therapy using CsA with low-dose corticosteroid for the treatment of severe AA and we also wanted to determine the safe therapeutic concentration of CsA in the peripheral blood.


METHODS
We treated 34 cases of severe AA with combination therapy for 24 weeks and we evaluated the efficacy at 12 and 24 weeks. We monitored the peripheral blood concentration of CsA to determine the therapeutic range of CsA that has the fewest side effects.


RESULTS
Of the patients, 77.4% (n=24) and 22.6% (n=10) were classified in the responder and poor-responder groups, respectively. The mean trough concentration of CsA was 95.1 and 101.2 ng/ml in the responder and poor-responder groups, respectively. For the patients with side effects associated with CsA, the mean CsA concentration was 195.8 ng/ml.


CONCLUSIONS
We found that combination therapy with systemic CsA and low-dose corticosteroids effectively treats severe AA and this therapy results in a safe, therapeutic concentration of CsA in the peripheral blood.
Department of Dermatology, Inje University School of Medicine, Busan, Korea.
Deborah
D
Lee
Department of Dermatology, Inje University School of Medicine, Busan, Korea.
Doo Jin
DJ
Oh
Gowoonsesang Dermatology Clinic, Busan, Korea.
Jung Wook
JW
Kim
Gowoonsesang Dermatology Clinic, Busan, Korea.
Sung Wook
SW
Park
Clinical Trial Center, Busan Paik Hospital, Busan, Korea.
Min Kyung
MK
Oh
Department of Dermatology, Inje University School of Medicine, Busan, Korea.
Ho Suk
HS
Sung
Department of Dermatology, Inje University School of Medicine, Busan, Korea.
Seon Wook
SW
Hwang
Alopecia areata; Cyclosporine A; Low-dose corticosteroids