Methotrexate as a first-line corticosteroid-sparing therapy in a cohort of uveitis and scleritis
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 followi...
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| Veröffentlicht in: | Ocular immunology and inflammation 2003-06, Vol.11 (2), p.131-139 |
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| creator | Kaplan-Messas, Audrey Barkana, Yaniv Avni, Isaac Neumann, Ron |
| description | 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. |
| doi_str_mv | 10.1076/ocii.11.2.131.15919 |
| format | Article |
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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.</description><identifier>ISSN: 0927-3948</identifier><identifier>EISSN: 1744-5078</identifier><identifier>DOI: 10.1076/ocii.11.2.131.15919</identifier><identifier>PMID: 14533032</identifier><language>eng</language><publisher>England: Informa UK Ltd</publisher><subject>Adolescent ; Adrenal Cortex Hormones - administration & dosage ; Adult ; Aged ; Child ; Child, Preschool ; Dose-Response Relationship, Drug ; Female ; Humans ; Immunosuppressive Agents - therapeutic use ; Male ; Methotrexate - therapeutic use ; Middle Aged ; Retrospective Studies ; Scleritis - drug therapy ; Scleritis - physiopathology ; Uveitis - drug therapy ; Uveitis - physiopathology ; Visual Acuity</subject><ispartof>Ocular immunology and inflammation, 2003-06, Vol.11 (2), p.131-139</ispartof><rights>2003 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted 2003</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c507t-9f781df5997498c959c0e585aba19fa95073a2ef6382f5e637b6c7c7de0f806e3</citedby><cites>FETCH-LOGICAL-c507t-9f781df5997498c959c0e585aba19fa95073a2ef6382f5e637b6c7c7de0f806e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.tandfonline.com/doi/pdf/10.1076/ocii.11.2.131.15919$$EPDF$$P50$$Ginformahealthcare$$H</linktopdf><linktohtml>$$Uhttps://www.tandfonline.com/doi/full/10.1076/ocii.11.2.131.15919$$EHTML$$P50$$Ginformahealthcare$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,59647,59753,60436,60542,61221,61256,61402,61437</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14533032$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kaplan-Messas, Audrey</creatorcontrib><creatorcontrib>Barkana, Yaniv</creatorcontrib><creatorcontrib>Avni, Isaac</creatorcontrib><creatorcontrib>Neumann, Ron</creatorcontrib><title>Methotrexate as a first-line corticosteroid-sparing therapy in a cohort of uveitis and scleritis</title><title>Ocular immunology and inflammation</title><addtitle>Ocul Immunol Inflamm</addtitle><description>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.</description><subject>Adolescent</subject><subject>Adrenal Cortex Hormones - administration & dosage</subject><subject>Adult</subject><subject>Aged</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Dose-Response Relationship, Drug</subject><subject>Female</subject><subject>Humans</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>Male</subject><subject>Methotrexate - therapeutic use</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Scleritis - drug therapy</subject><subject>Scleritis - physiopathology</subject><subject>Uveitis - drug therapy</subject><subject>Uveitis - physiopathology</subject><subject>Visual Acuity</subject><issn>0927-3948</issn><issn>1744-5078</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU9v1DAQxS0EotvCJ6iEfOKW1I7jOD4UCVXQViriAmfjdcaNq2y8HTuU_fZ42ZUQl3IajfR7b_48Qs45qzlT3UV0IdSc103NBa-51Fy_ICuu2raSTPUvyYrpRlVCt_0JOU3pgTHWas1fkxPeSiGYaFbkxxfIY8wIv2wGahO11AdMuZrCDNRFzMHFlAFjGKq0tRjme5pHQLvd0TAX3MWxUDR6uvyEkEOxmAea3AS4796QV95OCd4e6xn5_vnTt6ub6u7r9e3Vx7vKlWVzpb3q-eCl1qrVvdNSOwayl3ZtufZWF0jYBnwn-sZL6IRad045NQDzPetAnJH3B98txscFUjabkBxMk50hLskoqbqmK3f_D-S6awunCigOoMOYEoI3WwwbizvDmdknYPYJGM5NY0oC5k8CRfXuaL-sNzD81RxfXoAPByDMPuLGPkWcBpPtboro0c4uJCOen3D5j8EIdsqjswjmIS44ly8_u-Fvb9GtIQ</recordid><startdate>20030601</startdate><enddate>20030601</enddate><creator>Kaplan-Messas, Audrey</creator><creator>Barkana, Yaniv</creator><creator>Avni, Isaac</creator><creator>Neumann, Ron</creator><general>Informa UK Ltd</general><general>Taylor & Francis</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>20030601</creationdate><title>Methotrexate as a first-line corticosteroid-sparing therapy in a cohort of uveitis and scleritis</title><author>Kaplan-Messas, Audrey ; Barkana, Yaniv ; Avni, Isaac ; Neumann, Ron</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c507t-9f781df5997498c959c0e585aba19fa95073a2ef6382f5e637b6c7c7de0f806e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adolescent</topic><topic>Adrenal Cortex Hormones - administration & dosage</topic><topic>Adult</topic><topic>Aged</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Dose-Response Relationship, Drug</topic><topic>Female</topic><topic>Humans</topic><topic>Immunosuppressive Agents - therapeutic use</topic><topic>Male</topic><topic>Methotrexate - therapeutic use</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Scleritis - drug therapy</topic><topic>Scleritis - physiopathology</topic><topic>Uveitis - drug therapy</topic><topic>Uveitis - physiopathology</topic><topic>Visual Acuity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kaplan-Messas, Audrey</creatorcontrib><creatorcontrib>Barkana, Yaniv</creatorcontrib><creatorcontrib>Avni, Isaac</creatorcontrib><creatorcontrib>Neumann, Ron</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Ocular immunology and inflammation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kaplan-Messas, Audrey</au><au>Barkana, Yaniv</au><au>Avni, Isaac</au><au>Neumann, Ron</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Methotrexate as a first-line corticosteroid-sparing therapy in a cohort of uveitis and scleritis</atitle><jtitle>Ocular immunology and inflammation</jtitle><addtitle>Ocul Immunol Inflamm</addtitle><date>2003-06-01</date><risdate>2003</risdate><volume>11</volume><issue>2</issue><spage>131</spage><epage>139</epage><pages>131-139</pages><issn>0927-3948</issn><eissn>1744-5078</eissn><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. 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| subjects | Adolescent Adrenal Cortex Hormones - administration & dosage Adult Aged Child Child, Preschool Dose-Response Relationship, Drug Female Humans Immunosuppressive Agents - therapeutic use Male Methotrexate - therapeutic use Middle Aged Retrospective Studies Scleritis - drug therapy Scleritis - physiopathology Uveitis - drug therapy Uveitis - physiopathology Visual Acuity |
| title | Methotrexate as a first-line corticosteroid-sparing therapy in a cohort of uveitis and scleritis |
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