TY - JOUR
AU - Amol Sura
AU - Yuwei Sun
AU - Amit Reddy
AU - S Rathinam
AU - John Gonzales
AU - Radhika Thundikandy
AU - Rajesh Vedhanayaki
AU - Anuradha Kanakath
AU - Bala Murugan
AU - Thuy Doan
AU - Lyndell Lim
AU - Eric Suhler
AU - Hassan Al-Dhibi
AU - Nisha Acharya
AU - FAST Group
AB - <p><b>PURPOSE: </b>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.</p>

<p><b>METHODS: </b>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&nbsp;g daily). A pre-specified dose reduction protocol could be employed for intolerable side effects. Primary analysis was performed at 6&nbsp;months.</p>

<p><b>RESULTS: </b>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).</p>

<p><b>CONCLUSION: </b>Dose reduction of antimetabolites was not associated with worse outcomes in this subanalysis of a uveitis trial.</p>

BT - Ocul Immunol Inflamm
DA - 2023 Jan 26
DO - 10.1080/09273948.2023.2165949
J2 - Ocul Immunol Inflamm
LA - eng
N2 - <p><b>PURPOSE: </b>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.</p>

<p><b>METHODS: </b>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&nbsp;g daily). A pre-specified dose reduction protocol could be employed for intolerable side effects. Primary analysis was performed at 6&nbsp;months.</p>

<p><b>RESULTS: </b>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).</p>

<p><b>CONCLUSION: </b>Dose reduction of antimetabolites was not associated with worse outcomes in this subanalysis of a uveitis trial.</p>

PY - 2023
SP - 1
EP - 6
T2 - Ocul Immunol Inflamm
TI - Reduced Dose Methotrexate and Mycophenolate Mofetil in Noninfectious Uveitis: A Sub-Analysis from the First-Line Antimetabolites as Steroid Sparing Therapy (FAST) Trial.
SN - 1744-5078
ER -