Corticosteroid Exposure Comparable With Methotrexate, Mycophenolate Mofetil

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Researchers evaluated corticosteroid exposure and patient adherence in patients receiving methotrexate or mycophenolate mofetil to treat noninfectious uveitis.

This article is part of Ophthalmology Advisor’s Focus on Retina coverage from the 2021 meeting of the American Academy of Ophthalmology, held in New Orleans from November 12 to 15, 2021. The team at Ophthalmology Advisor will be reporting on a variety of the research presented by the retinal experts at the AAO. Check back for more from the AAO 2021 Meeting.

 

Patients taking methotrexate (MTX) or mycophenolate mofetil (MMF) for noninfectious uveitis had comparable corticosteroid exposure, according to an investigation presented at the American Academy of Ophthalmology 2021 meeting, held in New Orleans from November 12-15.

The team looked at 194 patients enrolled in the First-line Antimetabolites as Steroid-sparing Treatment (FAST) Uvetitus Trial and randomly assigned to receive either MTX or MMF. Patients were prescribed prednisone, and adherence and success vs failure in controlling uveitis were compared in the 2 antimetabolite groups. 

The median prednisone dose prescribed to patients with treatment success was 18.2 vs 17.7 mg/day in the MTX group vs the MMF group. In the groups with treatment failure, the median prednisone dose was 24.1 and 27.2 mg/day in the MTX group and MMF group, respectively. The researchers also looked at time to reach corticosteroid-sparing control of inflammation and found similar values for the 2 groups: 106 days for the MTX group and 105 days for the MMF group. 

In terms of patient adherence, the team found the median absolute deviation between the prednisone prescribed and taken to be 0.5 vs 1.6 mg/day for the success group vs the failure group in the MTX group and 0.5 versus 1.3 mg/day in the MMF group, suggesting that patient adherence was critical for treatment success. 

“Treatment with MTX or MMF results in similar corticosteroid exposure and time to corticosteroid-sparing control of inflammation,” the researchers concluded. 

Visit Ophthalmology Advisor’s conference section for the complete Focus on Retina coverage from the AAO 2021.

 

Reference 

Bul AD, Kong CL, Acharya N. Corticosteroid exposure and adherence in patients from the First-line Antimetabolites as Steroid-Sparing Treatment (FAST) Trial. Paper presented at: The American Academy of Ophthalmology 2021 Annual Meeting; November 12-15, 2021; New Orleans. Abstract PA011.