Cyclosporin Alopecia Areata Trial Produces Insignificant Results

Posted by Sarah

In this article: Hair Loss | Alopecia

A small-scale clinical trial investigating the potential use of cyclosporin as a treatment for moderate to severe forms of Alopecia Areata has produced fairly disappointing results.

The immunosuppressant drug, also known as cyclosporine or cyclosporine A and commonly used to treat rheumatoid arthritis, Crohn's disease or given to organ transplant patients to help prevent rejection, previously showed promise as a potential hair loss solution in a 2018 trial, when it was used in a shampoo format.

Cyclosporin - cyclosporine - ciclosporin

Authors of this new study, carried out in Melbourne, Australia, state in their published findings, however, that the response "approached but did not reach a statistically significant difference between cyclosporin and placebo."

Further tests may be warranted

Alopecia Areata is an autoimmune disorder which causes the body to attack its own hair follicles, resulting in sudden hair loss. This ranges in severity depending on the phenotype, from the scalp-only form which presents as bald spots or patches (Alopecia Areata), to complete hairloss of the head (Alopecia Totalis) or from head-to-toe (Alopecia Universalis).

Given cyclosporin dampens the immune system and is currently used to treat other autoimmune diseases, it seems a clear candidate for an Alopecia Areata trial.

This three month trial comprised 32 participants aged between 18 and 65 years, with a diagnosis of Alopecia Areata, Totalis or Universalis. The mean candidate age was 41 years old and it was mostly women who took part.

Half of the group were given 4mg of cyclosporin per kg of their body weight per day and the other half were given matching amounts of a placebo.

"The cyclosporin group had a greater proportion of participants achieving at least a 50% reduction of SALT score (31.3% versus 6.3%; p=0.07) and greater proportion of participants achieving a 1 grade improvement in eyelash (18.8% versus 0%; p=0.07) and eyebrow (31.3% versus 0%; p=0.02) scales compared to placebo," confirms the Australian team.

Therefore, at the end of the three months, results between the two arms
- measured by a number of methods including SALT score, quality of life questionnaires, blood work, photography and assessments of eyebrows and lashes - were not considered statistically significant.

Given the short timeline and small number of participants, it may be the case that further, wider-ranging clinical trials, perhaps with more subjects, testing various timelines and dosages may be considered in the future.


Test subjects should avoid grapefruit

Often there are certain contraindications for medications - things that should be avoided as they have been shown not interact well with the prescribed drug. In the case of cyclosporin there is something of a quirky requirement - that patients taking it avoid eating grapefruits or drinking grapefruit juice.

The British Association of Dermatologists states that cyclosporine users should avoid consuming grapefruit whilst on this medication as it "may alter the metabolism of the drug". This may, in turn, lead to an increased propensity to side effects.

Until a medical regulatory body-authorised Alopecia Areata treatment option is discovered, anyone worried about sudden hair loss should speak to a professional as soon as possible for advice on dealing with alopecia.

For adults where only the scalp is affected, a hair loss specialist may be consulted, and for adults losing hair from their face and/or body as well as their scalp, it is best to go to your GP or dermatologist for treatment advice. This is also the case for children under 16.

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The Belgravia Centre

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Posted by Sarah

In this article: Hair Loss | Alopecia

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