Efficacy and Tolerability of Methotrexate for Idiopathic Granulomatous Mastitis: A Systematic Review and Meta‐Analysis.

Background: Idiopathic granulomatous mastitis (IGM) is a challenging inflammatory breast disease with limited standardized treatment guidelines. Methods: This meta‐analysis systematically evaluated the efficacy and safety of methotrexate (MTX) in IGM, pooling data from observational studies. We asse...

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Publicado en:Breast Journal Vol. 2026; pp. 1 - 14
Autores principales: Han, Ying, Shi, LiHui, Zhang, YanRan, Wani, Imtiaz
Formato: meta analysis research systematic review tables/charts Journal Article
Publicado: Wiley-Blackwell 2/13/2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2/13/2026
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      pub: Wiley-Blackwell
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        atl: Efficacy and Tolerability of Methotrexate for Idiopathic Granulomatous Mastitis: A Systematic Review and Meta‐Analysis.
      aug:
        au:
          Han, Ying
          Shi, LiHui
          Zhang, YanRan
          Wani, Imtiaz
        affil: Department of Science and Education,, Tongzhou Maternal and Child Health Hospital of Beijing,, Beijing, 101100,, China
      sug:
        subj:
          Mastitis Drug Therapy
          Granuloma Drug Therapy
          Methotrexate Therapeutic Use
          Drug Efficacy Evaluation
          Patient Safety Evaluation
          Drug Tolerance Evaluation
          Pathologic Complete Response Evaluation
          Recurrence Risk Factors
          Methotrexate Adverse Effects
          Treatment Termination
          Risk Assessment
          Human
          Funding Source
          Systematic Review
          Meta Analysis
          Female
          Adolescence
          Adult
          Middle Age
          Descriptive Statistics
          Confidence Intervals
          Inferential Statistics
          Drug Therapy, Combination
          PubMed
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          Cochrane Library
          Checklists
          Data Analysis Software
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          Iran
          Iraq
          China
          United States
          Linear Regression
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
      ab: Background: Idiopathic granulomatous mastitis (IGM) is a challenging inflammatory breast disease with limited standardized treatment guidelines. Methods: This meta‐analysis systematically evaluated the efficacy and safety of methotrexate (MTX) in IGM, pooling data from observational studies. We assessed complete remission rates, recurrence rates, and severe side effects leading to MTX discontinuation using both common and random effects models, accounting for heterogeneity. Results: Nine studies were included. In analyses without control groups, the pooled complete response rate for MTX was 61.6% (95% CI: 40.4–79.2%), with significant heterogeneity (I2 = 81.4%). Combination therapy showed a higher complete response rate in the common effect model (78.0%, 95% CI: 71.4–83.3%) compared to monotherapy (46.6%, 95% CI: 34.2–59.3%), though this difference was not significant in the random effects model. The overall pooled proportion of severe side effects leading to MTX discontinuation was low at 1.23% (95% CI: 0.40–3.74%) in the common effect model and 0.51% (95% CI: 0.03–9.37%) in the random effects model, with no significant heterogeneity. In controlled studies, MTX showed no significant difference in complete remission compared to steroid‐containing controls. Conclusion: Based on a pooled complete response rate of 61.6%, MTX appears to be an effective and well‐tolerated treatment for IGM, though substantial heterogeneity exists in uncontrolled studies.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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