Zu Hoerste, Melissa Meyer; Walscheid, Karoline; Tappeiner, Christoph; Zurek-Imhoff, Beatrix; Heinz, Carsten; Heiligenhaus, Arnd (2018). The effect of methotrexate and sulfasalazine on the course of HLA-B27-positive anterior uveitis: results from a retrospective cohort study. Graefe's archive for clinical and experimental ophthalmology, 256(10), pp. 1985-1992. Springer 10.1007/s00417-018-4082-x
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PURPOSE
To investigate the effect of methotrexate (MTX) or sulfasalazine (SSZ) on the course of HLA-B27-positive, remitting acute anterior uveitis (AAU).
METHODS
Forty-six patients with HLA-B27-positive AAU with or without associated systemic rheumatic disease either receiving MTX (n = 20), SSZ (n = 13), or no systemic immunomodulating treatment (Ctrl; n = 13) were studied retrospectively. Best-corrected visual acuity (BCVA), AAU relapse rate, and occurrence of uveitis-related ocular complications were analyzed at baseline (BL) and at 12-month follow-up (FU).
RESULTS
Groups did not differ regarding age, gender, and presence of associated systemic diseases. BCVA at baseline was significantly worse in patients receiving MTX (logMAR 0.39 ± 0.4) than in those treated with SSZ (0.17 ± 0.2; P = 0.05) or in controls (Ctrl; 0.14 ± 0.2; P = 0.009). At the 12-month endpoint, MTX treatment was associated with significantly improved BCVA (0.18 ± 0.4 logMAR; P = 0.004). In contrast, BCVA did not significantly change in patients treated with SSZ (0.17 ± 0.3 logMAR) or in the controls (0.11 ± 0.2 logMAR). The annual uveitis relapse rate significantly decreased with MTX (BL 3.6 ± 2.4 relapses to FU 0.7 ± 0.8; P = 0.0001) and SSZ (BL 3.6 ± 1.9 to FU 1.8 ± 2.4, P < 0.01), but not in the controls (BL 1.9 ± 1.4 vs 1.9 ± 1.7 FU). The complication rate was slightly reduced with MTX (BL 1.75 ± 1.2 complications present versus FU 1.3 ± 1.2, P = 0.09) but not with SSZ (BL 0.9 ± 0.8 to FU 1.3 ± 1.4; P = 0.4) or in the controls (BL and FU 1.0 ± 0.95; P = 0.7).
CONCLUSIONS
MTX and SSZ reduced the uveitis relapse rate in HLA-B27-positive AAU patients, with MTX showing a beneficial effect on AAU-related macular edema.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ophthalmology |
UniBE Contributor: |
Tappeiner, Christoph |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0721-832X |
Publisher: |
Springer |
Language: |
English |
Submitter: |
Christoph Tappeiner |
Date Deposited: |
01 Feb 2019 10:49 |
Last Modified: |
05 Dec 2022 15:24 |
Publisher DOI: |
10.1007/s00417-018-4082-x |
PubMed ID: |
30069748 |
Uncontrolled Keywords: |
Acute anterior uveitis (AAU) Human leukocyte antigen B27 (HLA-B27) Methotrexate Outcome Sulfasalazine |
BORIS DOI: |
10.7892/boris.123076 |
URI: |
https://boris.unibe.ch/id/eprint/123076 |
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