- A systematic review and meta-analysis indicates that methotrexate treatment is effective as monotherapy or in combination with corticosteroid for patients with alopecia areata (AA).
Why this matters
- Treatment of AA is challenging, and there is a lack of high-quality evidence to guide treatment.
- 35.8% of methotrexate patients experienced complete response (100% regrowth of hair), whereas 63.2% exhibited good/complete response (50%-100% regrowth of hair).
- Adults had significantly higher complete and good/complete response rates compared with pediatric patients (P=.001 for both).
- Methotrexate combined with corticosteroids was associated with higher odds of good/complete response compared with methotrexate alone (OR, 2.73; P=.018).
- The pooled recurrence rate was 47.7% (52.0% in adults vs 31.7% in pediatric patients; P=.19).
- The pooled complication rate was 22.1% (24.2% in adults vs 14.5% in pediatric patients; P=.31).
- Systematic review and meta-analysis of 16 studies according to recommended PRISMA guidelines.
- Funding: None.
- Meta-analysis was based on retrospective, observational studies with heterogeneity.