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

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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References

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Published

29-04-2024

How to Cite

1.
Sadiq Malik S, Anwar A, Akhtar A, Yousaf F, Bashir U, Malik S. Effectiveness of Methotrexate Versus Cyclosporine in the Management of Moderate to Severe Atopic Dermatitis- Meta-Analysis of Randomised Controlled Trials. Pak Armed Forces Med J [Internet]. 2024 Apr. 29 [cited 2024 May 24];74(2):574-82. Available from: https://pafmj.org/PAFMJ/article/view/12080

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