Low-Dose Systemic Methotrexate Therapy for Recalcitrant Alopecia Areata

January 2017 in “ Annals of Dermatology ”

Seul-Ki Lim, Cho-Ah Lim, In Sun Kwon, Myung Im, Young‐Joon Seo, Chang Deok Kim, Jeung‐Hoon Lee, Young Lee

methotrexate alopecia areata recalcitrant alopecia areata LD-MTX elevated liver enzymes gastrointestinal discomfort MTX

Studysummary In this retrospective study, low-dose methotrexate was observed to be effective and well-tolerated in treating recalcitrant alopecia areata multiplex, achieving complete or near-complete hair regrowth in about 90% of patients despite some experiencing elevated liver enzymes and gastrointestinal discomfort. Our plain-language summary of this paper — not a Tressless recommendation.

In a study involving 29 patients with recalcitrant alopecia areata (AA), low-dose methotrexate (LD-MTX) therapy was evaluated for its efficacy and tolerance. The treatment, administered twice weekly with an average maximum dose of 14.48 mg per week, resulted in complete hair regrowth (100%) in 48.3% of patients and significant regrowth (75%-90%) in 41.4% of patients. However, 3 patients with disease durations over 24 months showed poor response. Relapse occurred in 31% of those with more than 75% regrowth. Common side effects included elevated liver enzymes and gastrointestinal discomfort. Overall, LD-MTX was found to be an effective and well-tolerated treatment for recalcitrant AA multiplex.

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