Use of methotrexate for autoimmune hearing loss

O. Tirzaman, J. Kasperbauer, E. L. Matteson, G. W. Facer, C. W. Beatty, D. A. Fabry, T. J. McDonald

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


To assess the efficacy of low-dose methotrexate (MTX) given long-term for the treatment of autoimmune hearing loss, we performed a prospective open-label study of 11 patients with treatment-refractory autoimmune hearing loss. All patients had ongoing episodic worsening of hearing in I or both ears before enrollment despite traditional medical therapy. The MTX dose was 7.5 to 17.5 mg/wk. Hearing loss and vertigo were evaluated at baseline and at completion of the study. Hearing improvement was defined as an improvement in the pure tone threshold (PT) average of >10 dB or an increase in speech discrimination (SD) of >15%, whereas worsening was defined as a worsening of >10 dB in PT or a decrease of >15% in SD in at least 1 ear. The MTX was well tolerated. Among the 6 patients with Meniere's disease, 4 had improvement or resolution of vertigo, while 2 had no improvement, Disequilibrium improved in all 3 patients with Cogan's syndrome. According to the parameters defined above, hearing improved in 9 patients (82%), was unchanged in 1 patient (9%), and worsened in 1 patient (9%). Long-term low-dose MTX therapy may be a useful therapy for some patients who have hearing loss with a presumptively autoimmune-mediated component that is refractory to traditional therapies.

Original languageEnglish (US)
Pages (from-to)710-714
Number of pages5
JournalAnnals of Otology, Rhinology and Laryngology
Issue number8 I
StatePublished - 2000


  • Autoimmune hearing loss
  • Cogan's syndrome
  • Meniere's disease
  • Methotrexate

ASJC Scopus subject areas

  • Otorhinolaryngology


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