Efficacy and Safety of Methotrexate in Alopecia Areata

    Mariana Hammerschmidt, Fabiane Mulinari Brenner
    TLDR Methotrexate is a promising and safe treatment for severe alopecia areata, with better results when combined with corticosteroids.
    The study from 2014 evaluated methotrexate (MTX) in 31 patients with alopecia areata (AA) and found that 67.7% experienced over 50% hair regrowth, especially those with less than 5 years of disease progression, age over 40, male patients, and those with multifocal AA. Combination therapy with systemic corticosteroids showed higher regrowth rates (77.3%) compared to MTX alone (44.4%). The therapeutic dose ranged from 10-25 mg/week, with no serious adverse effects reported. Relapse occurred in 33.3% of patients with significant regrowth. The study concluded that MTX is a promising and safe treatment for severe AA, either alone or combined with corticosteroids, but larger trials are needed to confirm its efficacy as a first-line therapy.
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