Reduced Dose Methotrexate and Mycophenolate Mofetil in Noninfectious Uveitis: A Sub-Analysis from the First-Line Antimetabolites as Steroid Sparing Therapy (FAST) Trial.
- Resource Type
- Academic Journal
- Authors
- Sura AA; Francis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.; Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA.; Sun Y; Francis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.; Reddy AK; Francis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.; Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA.; Rathinam SR; Uvea Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Madurai, India.; Gonzales JA; Francis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.; Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA.; Thundikandy R; Uvea Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Madurai, India.; Vedhanayaki R; Uvea Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Madurai, India.; Kanakath A; Uvea Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Coimbatore, India.; Murugan B; Uvea Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Pondicherry, India.; Doan TA; Francis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.; Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA.; Lim LL; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia.; Suhler EB; Casey Eye Institute, Oregon Health and Science University, OHSU-PSU School of Public Health, and Portland Veterans' Affairs Health Care System, Portland, Oregon, USA.; Al-Dhibi HA; Division of Vitreoretinal Surgery and Uveitis, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia.; Acharya NR; Francis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.; Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA.
- Source
- Publisher: Informa Healthcare Country of Publication: England NLM ID: 9312169 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1744-5078 (Electronic) Linking ISSN: 09273948 NLM ISO Abbreviation: Ocul Immunol Inflamm Subsets: MEDLINE
- Subject
- Language
- English
Purpose: Some patients taking methotrexate (MTX) or mycophenolate mofetil (MMF) experience intolerable side effects at full doses. We evaluated whether dose reduction affected treatment outcomes in uveitis patients.
Methods: Subanalysis of the First-line Antimetabolites as Steroid-sparing Treatment (FAST) uveitis trial. Patients were randomized to receive MTX (25 mg weekly) or MMF (3 g daily). A pre-specified dose reduction protocol could be employed for intolerable side effects. Primary analysis was performed at 6 months.
Results: 43/194 patients (22%) required dose reduction. 88/151 patients (58%) on maximum doses and 32/43 patients (74%) on reduced doses were deemed treatment successes at 6 months. The odds ratio point estimate (1.60, 95% CI 0.72-3.74) favored dose-reduction but this was not significant. Following reduction, adverse events improved at the subsequent study visit (79 events reduced to 63 events).
Conclusion: Dose reduction of antimetabolites was not associated with worse outcomes in this subanalysis of a uveitis trial.