Efficacy and tolerability of methotrexate in severe childhood alopecia areata

Royer, Mathieu; Bodemer, Christine; Vabres, P.; Pajot, C.; Barbarot, S.; Paul, C.; Mazereeuw, J.

doi:10.1111/j.1365-2133.2011.10383.x

Cited by 74 publications

(68 citation statements)

References 15 publications

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“…Recently, the efficacy of MTX has been assessed in children with severe AA in whom all but one initially received oral corticosteroids, suggesting that this initial treatment could influence the course of the disease [16] as suggested previously [13]. This is also in accordance with our results (70% of satisfactory regrowth at month 18), which could suggest that the initial treatment by HDPCT influences the overall response.…”

Section: Discussionsupporting

confidence: 82%

Interest of High-Dose Pulse Corticosteroid Therapy Combined with Methotrexate for Severe Alopecia Areata: A Retrospective Case Series

Droitcourt

Milpied²,

Ezzedine³

et al. 2012

Dermatology

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Background: The combination of systemic pulse corticosteroids and methotrexate in the treatment of severe alopecia areata has never been reported. Objective: The objective of this work was to give arguments for the efficacy and safety of this combined treatment. Methods: This was a retrospective case series of patients treated with intravenous 500 mg methylprednisolone per day for 3 consecutive days monthly during 3 months plus methotrexate initiated at the end of the second pulse regimen. We reviewed all case notes of patients who received this regimen between January 1 2007 and December 1 2010. Results: Twenty patients were treated. Data on hair regrowth at month 12 were available for all patients; 14 patients were still receiving the treatment on December 1 2010, 2 patients were lost of follow-up, and 4 patients had stopped the treatment. Of the 14 patients who were still receiving the treatment regimen at month 18, 10 (10/20, 50%) had total hair regrowth and 4 (4/20, 20%) had incomplete but satisfactory hair regrowth. The treatment was well tolerated. Conclusion: The initial treatment by pulse intravenous corticosteroids may influence the overall response. This approach should be evaluated in a larger series of patients.

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Section: Discussionsupporting

confidence: 82%

Interest of High-Dose Pulse Corticosteroid Therapy Combined with Methotrexate for Severe Alopecia Areata: A Retrospective Case Series

Droitcourt

Milpied²,

Ezzedine³

et al. 2012

Dermatology

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“…As there is only 1 previous study of MTX use in 6 patients with vitiligo and no studies comparing MTX and OMP, further studies are required to corroborate our results. Also our study used 24 weeks of follow-up; long-term controlled studies with blinded assessment of a larger cohort are required to augment the findings of our study [22,23,24,25]. …”

Section: Discussionmentioning

confidence: 99%

A Randomized Comparative Study of Oral Corticosteroid Minipulse and Low-Dose Oral Methotrexate in the Treatment of Unstable Vitiligo

Singh¹,

Kumaran²,

Bains³

et al. 2015

Dermatology

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Background: Despite continued progress towards elucidation of the biochemical, genetic and immunopathological pathways in vitiligo, a definitive cure remains elusive. The initial therapy must be directed to arrest disease progression. Oral minipulse therapy (OMP) with betamethasone/dexamethasone has been tried and shown to be an effective modality to arrest the disease progression in vitiligo. Objectives: Methotrexate (MTX) is a time-tested effective treatment extensively used in various autoimmune disorders with good efficacy, safety and tolerability on a long-term basis. We intended to compare the efficacy of MTX with that of OMP in patients with unstable vitiligo vulgaris. Patients and Methods: In a prospective randomized open label study, 52 patients with vitiligo were divided into two groups. Patients in group 1 received 10 mg methotrexate weekly. Group 2 patients received corticosteroid OMP which comprised tablets of dexamethasone 2.5 mg (5 tablets), taken on 2 consecutive days in a week (total weekly dose of 5 mg dexamethasone). Results: In the MTX group, among 25 patients analyzed, during the course of treatment for 24 weeks, overall 6 patients developed new vitiliginous lesions. In the OMP group, 7/25 patients developed new lesions. Statistical correlation between the two groups showed no significance in the number of patients who developed new lesions (increasing disease activity) in either of the groups. At the end of the study, it was demonstrated that patients in both groups had a similar reduction in the vitiligo disease activity score. Conclusion: Our study demonstrated that both drugs are equally effective in controlling the disease activity of vitiligo. MTX can be used in patients with active vitiligo, wherever corticosteroids are contraindicated.

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“…2) Prednisone at 10 or 20 mg/day and MTX at 15 mg weekly [79]. 3) Royer et al showed that MTX could be used in children, as a second-line drug with good safety profile [80].…”

Section: Methotrexatementioning

confidence: 99%

Current and future pharmacotherapy for alopecia areata

Vázquez-Herrera

Tosti

2015

Expert Opinion on Orphan Drugs

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Efficacy and tolerability of methotrexate in severe childhood alopecia areata

Abstract: The efficacy of MTX in children with severe AA is variable. MTX may be considered for severe childhood AA in the absence of alternative effective treatments.

Cited by 74 publications

References 15 publications

Interest of High-Dose Pulse Corticosteroid Therapy Combined with Methotrexate for Severe Alopecia Areata: A Retrospective Case Series

Interest of High-Dose Pulse Corticosteroid Therapy Combined with Methotrexate for Severe Alopecia Areata: A Retrospective Case Series

A Randomized Comparative Study of Oral Corticosteroid Minipulse and Low-Dose Oral Methotrexate in the Treatment of Unstable Vitiligo

Current and future pharmacotherapy for alopecia areata

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