Cyclosporine or Methotrexate, Which One Is More Promising in the Treatment of Lichen Planopilaris?; a Comparative Clinical Trial Publisher Pubmed



Fatemi Naeini F¹ ; Mohaghegh F¹ ; Jelvan M¹ ; Asilian A¹ ; Saber M¹
Source: International Immunopharmacology Published:2020

Abstract

Background: Lichen Planopilaris (LPP) is a primary scarring alopecia with unknown etiology and its management is a challenge for dermatologists. We aimed to compare the safety and efficacy of methotrexate and cyclosporine in LPP patients. Methods: In a randomized clinical trials, 33 patients were randomly allocated to receive either 15-mg oral methotrexate per week or 3–5-mg/kg/day cyclosporine for six months. During the treatment course, side effects, signs/symptoms and laboratory test were assessed periodically. Lichen planopilaris activity index (LPPAI) was measured at baseline and 2, 4, and 6 months after the intervention. Score of both photography and patient's opinion were also obtained. The collected data were analyzed in SPSS software (Ver.25.0. Armonk, NY: IBM Corp). Results: Both medications had positive effects on the signs and symptoms of LPP with a significant difference between the variables (p < 0.05), and the results showed similar efficacy at the end of 6th months of the therapy with both cyclosporine and methotrexate (p > 0.05). Conclusions: Regarding the results of the present study, both cyclosporine and methotrexate are effective in treating refractory lichen planopilaris and we propose methotrexate as a possible earlier choice over cyclosporine. This study was registered in Iranian Registry of Clinical Trials (IRCT20190717044256N1). © 2020 Elsevier B.V.