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Low-Dose Systemic Methotrexate Therapy for Recalcitrant Alopecia Areata
Seul-Ki Lim1, Cho-Ah Lim1, In Sun Kwon2
1Department of Dermatology, Chungnam National University School of Medicine, Daejeon, Korea.
Annals of Dermatology
|June 2, 2017
Summary
Systemic low-dose methotrexate (LD-MTX) effectively treats recalcitrant alopecia areata (AA) multiplex, with significant hair regrowth in most patients. While generally well-tolerated, potential side effects include elevated liver enzymes and gastrointestinal issues.
Area of Science:
- Dermatology
- Immunology
- Pharmacology
Background:
- Alopecia areata (AA) is a challenging autoimmune skin condition.
- It involves a T-cell-mediated autoimmune process.
- Systemic immunosuppressive therapy is a common treatment approach for AA.
Purpose of the Study:
- To assess the efficacy and safety of systemic low-dose methotrexate (LD-MTX) for treating recalcitrant alopecia areata multiplex.
- To evaluate treatment response based on disease severity, duration, MTX dosage, and drug safety.
Main Methods:
- Retrospective, non-controlled study design.
- Inclusion of 29 patients with recalcitrant AA.
- Treatment with LD-MTX, administered twice weekly.
Main Results:
- Significant hair regrowth (A5: 100%, A4: 75%-90%) observed in 90% of patients.
- Poor response noted in 3 patients with disease duration over 24 months.
- Relapse occurred in 31% of patients with substantial regrowth; common side effects included elevated liver enzymes and GI discomfort.
Conclusions:
- Systemic low-dose methotrexate (LD-MTX) demonstrates efficacy in treating recalcitrant alopecia areata multiplex.
- The treatment is generally well-tolerated.
- Longer disease duration may be associated with a poorer response to LD-MTX.
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