EFFICACY OF METHOTREXATE ALONE OR WITH LOW-DOSE PREDNISONE IN ALOPECIA AREATA TOTALIS

Authors

  • H MUGHAL Department of Dermatology Bilawal Medical College for Boys, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro, Pakistan
  • MH ABDULLAH Department of General Surgery, Niazi Medical and Dental College Sargodha, Pakistan
  • A JAMIL Department of Dermatology, Azra Naheed Medical and Dental College Lahore, Pakistan
  • A MALIK Department of Dermatology, University College of Medicine and Dentistry (UCMD) /University of Lahore Teaching Hospital, Pakistan
  • S RASHEED Department of Plastic/Reconstructive Surgery and Burns Unit, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro, Pakistan
  • F KHATOON Department of Biochemistry, College of Medicine University of Hail. Kingdom of Saudia Arabia (KSA).

DOI:

https://doi.org/10.54112/bcsrj.v2023i1.332

Keywords:

METHOTREXATE, LOW-DOSE

Abstract

This study aimed to evaluate the efficacy of methotrexate alone or in combination with low-dose prednisone in treating alopecia areata totalis. A randomized controlled trial was conducted among 100 patients diagnosed with alopecia areata totalis. Participants were randomly assigned to two treatment groups: Group A received methotrexate alone, and Group B received methotrexate in combination with low-dose prednisone. The primary outcome measure was the proportion of patients achieving hair regrowth at the end of the treatment period. Secondary outcomes included the time of hair regrowth, the duration of treatment response, and adverse events. Of the 100 patients, 50 were assigned to Group A and 50 to Group B. The study findings revealed that both treatment regimens, methotrexate alone and methotrexate with low-dose prednisone, showed efficacy in promoting hair regrowth in patients with alopecia areata totalis. In Group A, 30 patients (60%) achieved hair regrowth, while in Group B, 40 (80%) achieved hair regrowth. The combination therapy group demonstrated a higher proportion of patients achieving hair regrowth than the methotrexate-alone group. The time for hair regrowth was also shorter in the combination therapy group compared to the methotrexate alone group. Adverse events were minimal and comparable between the two groups. The results of this study suggest that both methotrexate alone and methotrexate in combination with low-dose prednisone are effective treatment options for alopecia areata totalis. The combination therapy showed superior efficacy in achieving hair regrowth and reducing the time to regrowth compared to methotrexate alone. The findings support the use of combination therapy as a potential treatment approach for patients with alopecia areata totalis. However, further research with a larger sample size is warranted to validate these results and establish the optimal dosing and long-term safety of combination therapy in this patient population.

Downloads

Download data is not yet available.

References

Joly, Pascal. "The Use of Methotrexate Alone or in Combination with Low Doses of Oral Corticosteroids in the Treatment of Alopecia Totalis or Universalis." Journal of the American Academy of Dermatology, vol. 55, no. 4, 2006, pp. 632-636, https://doi.org/10.1016/j.jaad.2005.09.010.

Pascal Joly (2006). The use of methotrexate alone or in combination with low doses of oral corticosteroids in the treatment of alopecia totalis or universalis. , 55(4), 0–636. doi:10.1016/j.jaad.2005.09.010

Thi Van AT, Tran Lan A, Ha Anh M, Nguyen Van T, Thi Minh PP, Trinh Minh T, Dinh Huu N, Vu Thanh T, Le Huyen M, Tran Hau K, Gandolfi M, Satolli F, Feliciani C, Tirant M, Vojvodic A, Lotti T. Efficacy and Safety of Methotrexate in Combination with Mini Pulse Doses of Methylprednisolone in Severe Alopecia Areata. The Vietnamese Experience. Open Access Maced J Med Sci [Internet]. 2019 Jan. 23 [cited 2023 Jun. 19];7(2):200-3. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2019.004

Firooz AR, Fouladi DF. Methotrexate Plus Prednisolone in Severe Alopecia Areata. American Journal of Drug Discovery and Development. 2013; 3: 188 193. https://doi.org/10.3923/ajdd.2013.188.193

Lemes L.R. Melo D.F.de Oliveira D.S.de La-Rocque M.Zompero C.Ramos P.M. Topical and oral minoxidil for hair disorders in pediatric patients: what do we know so far?.Dermatol Ther. 2020; 33e13950

Gregoriou S, Papafragkaki D, Kontochristopoulos G, Rallis E, Kalogeromitros D, Rigopoulos D. Cytokines and Other Mediators in Alopecia Areata. Mediators Inflamm. 2010;2010:928030.

Ruchiatan K, Avriyanti E, Hindritiani R, Puspitosari D, Suwarsa O, Gunawan H. Successful Therapy of Alopecia Universalis Using a Combination of Systemic Methotrexate and Corticosteroids and Topical 5% Minoxidil. Clin Cosmet Investig Dermatol. 2022;15:127-132

https://doi.org/10.2147/CCID.S349683

Alkhalifah A, Alsantali A, Wang E, McElwee KJ, Shapiro J. Alopecia areata update part I: clinical picture, histopathology, and pathogenesis. J Am Acad Dermatol. 2010;62(2):177–188. doi:10.1016/j.jaad.2009.10.032

Hammerschmidt M, Brenner FM. Efficacy and safety of methotrexate in alopecia areata. An Bras Dermatol. 2014;89(5):729–734. doi:10.1590/abd1806-4841.20142869

Anuset D, Perceau G, Bernard P, Reguiai Z. Efficacy and safety of methotrexate combined with low-to moderate-dose corticosteroids for severe alopecia areata. Dermatol. 2016;232(2):242–248. doi:10.1159/000441250

Kinoshita-Ise, Misaki, et al. "Oral Methotrexate Monotherapy for Severe Alopecia Areata: A Single Center Retrospective Case Series." Journal of Cutaneous Medicine and Surgery, 2021, https://doi.org/10.1177_120347542

Downloads

Published

2023-06-23

How to Cite

MUGHAL , H., ABDULLAH , M., JAMIL , A., MALIK , A., RASHEED , S., & KHATOON , F. (2023). EFFICACY OF METHOTREXATE ALONE OR WITH LOW-DOSE PREDNISONE IN ALOPECIA AREATA TOTALIS. Biological and Clinical Sciences Research Journal, 2023(1), 332. https://doi.org/10.54112/bcsrj.v2023i1.332

Most read articles by the same author(s)

1 2 3 4 5 > >>