DOI: 10.4103/ds.ds-d-25-00044 ISSN: 1027-8117

The efficacy and safety of monthly intravenous methylprednisolone pulse therapy in Taiwanese alopecia areata patients: A retrospective cohort study

Yang-Yi Chen, Hsin-Yi Huang, Yu-Wen Cheng, Yi-Jia Chen, Cheng-Che E. Lan
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Abstract

Background:

Intravenous methylprednisolone pulse (IVMP) therapy has been widely used for treating severe or recalcitrant alopecia areata (AA), but treatment protocols and efficacy vary.

Objectives:

This study aims to evaluate the efficacy of IVMP, identify predictive factors for treatment response, and optimize treatment protocols.

Methods:

A total of 122 AA patients received IVMP (500 mg/day for 3 consecutive days) and were followed for 12 months. Treatment response was classified as remarkable response (RR, ≥75% hair regrowth), partial response (PR, 25%–75% regrowth), and relapse (>10% new-onset hair loss).

Results:

RR was achieved in 55 patients (45.1%), with a relapse rate of 27.4% (mean interval: 5.3 months). Patients with a disease duration of <6 months had significantly better responses than those with ≥6 months (odds ratio = 0.148, P < 0.0001). RR rates did not significantly differ among IVMP session groups (1–3: 42.5%, 4–6: 60.9%, >6: 20%; P = 0.161). However, among patients with a disease duration ≥6 months, repetitive IVMP (2–11 sessions) was more effective than a single session (RR + PR: 68.6% vs. 20%, P = 0.0497). No severe adverse effects were observed.

Conclusion:

Monthly IVMP is a safe and effective treatment option for severe AA. Treatment regimens should be individualized based on disease duration and clinical response.

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