Methotrexate therapy for adult and paediatric moderate-to-severe atopic dermatitis: A PRISMA-compliant meta-analysis of data from daily practice.

Abstract

Of the 15 eligible studies identified via electronic searches in MEDLINE, EMBASE and CENTRAL in November 2022 for methotrexate therapy of moderate-to-severe atopic dermatitis, 12 were non-randomized controlled trial (non-RCT) studies with data from 437 patients (235 adults and 202 children). The response rates for short-term therapy were 77% [95% CI 55-99] (four studies; adults) - comparable to 81% [54-100] of RCTs (two studies; adults) (p = 0.63) - and 61% [43-79] (two studies; children), and for medium/long-term therapy were 88.9% [74.3-100.0] (four studies; adults) and 77.7% [61.5-94.0] (three studies; children). Children had a markedly lower rate of treatment discontinuation due to side effects [2.0% (five studies; children) vs. 14.9% (six studies; adults)], but were more likely to experience gastrointestinal disorders {relative risk (RR) 2.0 [1.44-2.71]}, fatigue (RR 2.3 [1.35-3.72]), headache (RR 2.8 [1.23-5.61]), and infections (RR 2.9 [2.18-3.58]). Other adverse events (children vs. adults) included hepatic disorders (32/176 vs. 35/305) and blood and lymphatic system/bone marrow disorders (25/148 vs. 19/184). Four serious adverse events were reported (children). Evidence from daily practice was limited by bias in the selection of participants in the study.

• Authors: Qiaohong Wang, Liheng Chen
• Journal: The Australasian journal of dermatology (Australas J Dermatol) Vol. 65 Issue 2 Pg. 114-127 (Mar 2024) ISSN: 1440-0960 [Electronic] Australia
• PMID: 37941136 (Publication Type: Journal Article, Meta-Analysis, Review)
• Copyright: © 2023 Australasian College of Dermatologists.

Chemical References

• Methotrexate

Topics

• Adult
• Child
• Humans
• Dermatitis, Atopic (drug therapy)
• Methotrexate (adverse effects)
• Non-Randomized Controlled Trials as Topic