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Sarah Escott, Julia Malalis, Yosuke Harada, David Mai, Debra A Goldstein; The influence of race and gender on the risk of hair loss secondary to methotrexate.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3432.
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To determine if there is a difference in terms of self-reported race and gender in the incidence of hair loss with methotrexate (MTX).
A retrospective review of all patients at a University based practice seen between August 2012 and September 2014 with a history of MTX treatment for uveitis was performed. Data collected included self-reported race, diagnosis, age at start of MTX therapy, self-reported hair loss, and both dose and duration of MTX at time of hair loss. To qualify for inclusion patients had a minimum of 6 months follow up after reported hair loss and cessation of MTX therapy.
Complete records of 97 uveitis patients who met the above criteria were reviewed. There were 25 males and 72 females. Of these, 28 patients self-reported African American race, 60 reported Caucasian, and the remaining 9 reported Asian, Hispanic, or Arabic ethnicity. Hair loss was reported in 9.2% of patients. Average age at the time of hair loss was 38.6 years (range 9-59 years). The incidence of hair loss was similar in women (10%) and men (8%); but was twice as common in African American (AA) patients (14%) compared with Caucasian patients (6.6%). All AA patients reporting hair loss were female, although there were only 3 AA males included in the analysis. Hair loss developed on weekly doses of 10-25mg MTX after an average exposure time of 24.8 months (range 7 months - 8 years). Reversal of hair loss occurred in all cases following cessation of treatment.
These findings suggest hair loss is twice as common in African Americans compared to Caucasians exposed to MTX. There was no effect of gender on risk of hair loss. Alopecia may develop on any dose of the drug, and is reversible on cessation of therapy. This information may be useful to clinicians when considering this medication for treatment, and in counseling patients on risk profile.
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