Reduced Dose Methotrexate and Mycophenolate Mofetil in Noninfectious Uveitis: A Sub-Analysis from the First-Line Antimetabolites as Steroid Sparing Therapy (FAST) Trial

for the FAST Research Group

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
JournalOcular Immunology and Inflammation
DOIs
StateAccepted/In press - 2023

Keywords

  • Antimetabolite
  • dosing
  • methotrexate
  • mycophenolate mofetil
  • uveitis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Ophthalmology

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