Effectiveness of Methotrexate Versus Cyclosporine in the Management of Moderate to Severe Atopic Dermatitis- Meta-Analysis of Randomised Controlled Trials

Sakina Sadiq Malik; Ayesha Anwar; Aisha Akhtar; Farrah Yousaf; Uzma Bashir; Saadia Malik

doi:10.51253/pafmj.v74i2.12080

Authors

Sakina Sadiq Malik Department of Dermatology, Pak Emirates Military Hospital/ National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Ayesha Anwar Department of Dermatology, Pak Emirates Military Hospital/ National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Aisha Akhtar Department of Dermatology, Pak Emirates Military Hospital/ National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Farrah Yousaf Department of Dermatology, Pak Emirates Military Hospital/ National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Uzma Bashir Department of Dermatology, Pak Emirates Military Hospital/ National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Saadia Malik Department of Dermatology, Pak Emirates Military Hospital/ National University of Medical Sciences (NUMS), Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i2.12080

Keywords:

Atopic dermatitis, Ciclosporin, Cyclosporine, Meta-analysis, Methotrexate

Abstract

Objective: To compare the effectiveness of Methotrexate (MTX) versus Cyclosporine (CyA) in the patients of moderate to severe atopic dermatitis (AD)

Study Design: Systematic review and Meta-analysis.

Methodology: After formulating our research team and PICO question rationally, a search strategy and literature search were carried out as per Cochrane guidelines. Full-text articles were retrieved after title and abstract screening per our inclusion criteria. The whole search process was documented in the form of a PRISMA flow chart. Team members made and filed data extraction sheets, and qualitative data synthesis was performed. Afterwards, a meta-analysis was carried out, involving a total of 03 randomized controlled trials. Revman was used to process the continuous and dichotomous data collected for our outcomes. RoB 2 was used to assess the risk of bias in the included studies. Grade pro-GDT was used to summarize the findings in the table.

Results: Pooled results from 3 RCTs showed that CyA in a 2.5mg/kg dose is better than MTX @0.4 mg/kg/week at 12 weeks in AD. At follow-up, MTX maintains better disease control, i.e., until 24 weeks post-treatment. MTX has a better safety profile than CyA.

Conclusion: MTX and CyA are both effective drugs for moderate to severe AD, but they have their pros and cons.

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