Citation:Xiao JY,Liang AY,Gao F,Zhao C,Zhang MF.Methotrexate for chronic non-necrotizing anterior scleritis in Chinese patients.Int J Ophthalmol 2022;15(8):1261-1265,doi:10.18240/ijo.2022.08.06
Methotrexate for chronic non-necrotizing anterior scleritis in Chinese patients
Received:February 21, 2021  Revised:February 16, 2022
Email this Article  Add to Favorites  Print
DOI:10.18240/ijo.2022.08.06
Key Words:methotrexate  non-necrotizing anterior scleritis  pharmacotherapy  corticosteroid-sparing  Chinese population
Fund Project:Supported by The Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (No.2018PT32029).
              
AuthorInstitution
Jun-Yan Xiao Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing , China
An-Yi Liang Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing , China; Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Eye Institute, Guangzhou , Guangdong Province, China
Fei Gao Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing , China; Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing , China
Chan Zhao Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing , China; Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing , China
Mei-Fen Zhang Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing , China; Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing , China
Hits: 123
Download times: 39
Abstract:
      AIM: To evaluate the effectiveness and corticosteroid-sparing capabilities of methotrexate (MTX) in the treatment of chronic non-necrotizing anterior scleritis in Chinese patients.

    METHODS: A retrospective chart review of all patients with active anterior scleritis between January 2015 and June 2019 was conducted. All patients received 10 to 15 mg/wk MTX orally, and corticosteroids (10 to 40 mg/d prednisolone or equivalent methylprednisolone) with slow tapering. Topical corticosteroid eye drops (1% prednisolone actate, 0.1% dexmathosone or 0.1% fluoromethalone) were applied to control comorbid anterior uveitis at presentation or during follow up. The main outcomes were inflammation control and corticosteroid-sparing success, and secondary outcomes were reduction of immunosuppression load and best-corrected visual acuity (BCVA).

    RESULTS: Thirty-two eyes (22 patients) were included. The proportion of patients who achieved corticosteroid-sparing success was 50.0% at 3mo and 77.3% at 12mo [8 (36.4%) patients discontinued corticosteroid]. The proportion of eyes that achieved inflammation control was 59.4% at 3mo and 78.1% at 12mo. The immunosuppression load was 5.14±0.87 at presentation and 2.76±2.34 at 12mo (P<0.01). BCVA maintained unchanged or improved in 29 (90.6%) of all affected eyes. One patient discontinued MTX treatment because of an abnormal liver function test, and no other serious adverse effects were observed.

    CONCLUSION: According to this pilot study, low dose MTX appear to be a well-tolerated and effective treatment for chronic non-necrotizing anterior scleritis patients in the Chinese population.

Supplementary Material
PDF Fulltext  Download reader  View/Add Comment