Efficacy and Safety of Long-Term Azathioprine Therapy for Severe Alopecia Areata: A 10-Year Cohort Study

This 10-year cohort study involving 63 patients at Tehran University of Medical Sciences found that long-term azathioprine (AZA) therapy is a safe and effective treatment for severe alopecia areata (AA). The study reported a significant mean hair regrowth rate of 92.69%, with male patients experiencing higher regrowth rates than females. AZA was well-tolerated, with mild adverse events like anemia and leukopenia, which were manageable with dose adjustments. The study noted better response in eyebrow hair compared to eyelash hair. Despite limitations such as the nonblinded design and lack of a control group, the study supports AZA as a viable alternative to systemic steroids, suggesting the need for further controlled trials.