alexa Methotrexate as a first-line corticosteroid-sparing therapy in a cohort of uveitis and scleritis.


Journal of Microbial & Biochemical Technology

Author(s): KaplanMessas A, Barkana Y, Avni I, Neumann R

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Abstract PURPOSE: To evaluate the clinical experience with methotrexate as a first-line corticosteroid-sparing drug in patients with resistant ocular inflammation. METHODS: We retrospectively studied 39 consecutive patients with uveitis (n = 36) or scleritis (n = 3) who were treated with methotrexate following inadequate control with corticosteroids lasting five years. Criteria for initiating treatment with methotrexate and defining outcome were strictly defined. RESULTS: The cohort included 21 females and 18 males, all Caucasians, with a mean age of 26.6 years (range: 3-73 years). Patients were followed up for 21.5 +/- 12.6 months. Treatment was discontinued due to side effects in 10 patients (26\%). Of the remaining 29 patients, full or partial control of inflammation was achieved in 23 (79\%). Response to treatment was observed after a mean of 2.4 +/- 0.8 months. Ten patients were fully controlled and discontinued methotrexate therapy after a mean of 20.9 +/- 9.2 months, with no recurrence of inflammation. Use of topical and systemic corticosteroids was markedly reduced in responsive patients. CONCLUSIONS: Methotrexate is recommended as a first-line adjunct to or replacement of systemic corticosteroids in the treatment of ocular inflammation.
This article was published in Ocul Immunol Inflamm and referenced in Journal of Microbial & Biochemical Technology

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