The Use of Low-Dose Methotrexate in Children with Chronic Anterior and Intermediate Uveitis

Malik, Amna; Pavésio, Carlos

doi:10.1016/j.jaapos.2006.03.008

Cited by 12 publications

(16 citation statements)

References 2 publications

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“…[8][9][10] Another retrospective study reports the use of MTX for threatening ocular inflammatory disease in patients with reactive arthritis. 16 To the authors' knowledge, no studies exist in which MTX has been used prospectively to prevent the recurrences of AAU.…”

Section: Discussionmentioning

confidence: 99%

“…Methotrexate (MTX) has been used to treat chronic anterior, intermediate, or posterior uveitis, [8][9][10] but its potential therapeutic benefit in the prevention of AAU flare-ups is unknown. MTX could have some advantages over other disease-modifying antirheumatic drugs (like SSZ), mainly due to the improved efficacy and ease of use for the patients.…”

Section: Introductionmentioning

confidence: 99%

“…14 As mentioned before, MTX has demonstrated efficacy in patients with more severe forms of uveitis. [8][9][10] Our objective was to evaluate the 1-year efficacy of MTX in the prevention of AAU recurrence.…”

Section: Introductionmentioning

confidence: 99%

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Methotrexate: an option for preventing the recurrence of acute anterior uveitis

Muñóz-Fernández

García‐Aparicio

Hidalgo

et al. 2008

Eye

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Aims To evaluate the efficacy of methotrexate (MTX) in preventing the recurrence of acute anterior uveitis (AAU). Methods This prospective, open, longitudinal study included patients from June 2002 to March 2005 who had either three or more episodes of AAU in the previous year, or a recurrence of AAU within 3 months before starting the trial. We excluded uveitis of infectious origin, masquerade syndromes, and patients with contraindications to MTX. The response criteria were defined as an absence of symptoms and the presence of a normal ophthalmologic examination. The study outcome compared the number of flare-ups of uveitis over an MTX-treated for 1 year to the number of flare-ups of the same group during the previous year without MTX. Results A total of 571 patients with uveitis were evaluated during the period of the study, and 10 fulfilled the inclusion criteria. One patient refused the treatment, and nine completed the study. The mean number of recurrences in the pre-MTX year was 3.4 (SD: 0.52), which was significantly reduced to 0.89 (SD: 1.17) in the year of treatment (P ¼ 0.011). Conclusion MTX treatment seems to reduce the number of flare-ups in patients with recurrent AAU.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Methotrexate: an option for preventing the recurrence of acute anterior uveitis

Muñóz-Fernández

García‐Aparicio

Hidalgo

et al. 2008

Eye

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“…(23/29) achieved full or partial control of inflammation 30–32. Methotrexate is also an effective agent in children with juvenile idiopathic arthritis (JIA) associated uveitis and chronic anterior or intermediate uveitis 33. Recently, intravitreal methotrexate has been tried with success in eyes with uveitis and uveitic CME 34–35.…”

Section: Existing Treatmentmentioning

confidence: 99%

Emerging drugs for uveitis

Larson¹,

Nussenblatt²,

Sen³

2011

Expert Opinion on Emerging Drugs

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Importance of the Field Uveitis is a challenging disease covering both infectious and noninfectious conditions. The current treatment strategies are hampered by the paucity of randomized controlled trials (RCTs) and few trials comparing efficacy of different agents. Areas Covered in this Review This review describes the current and future treatments of uveitis. A literature search was performed in PUBMED from 1965 to 2010 on drugs treating ocular inflammation with emphasis placed on more recent, larger studies. What the Reader Will Gain Readers should gain a basic understanding of current treatment strategies beginning with corticosteroids and transitioning to steroid sparing agents. Steroid sparing agents include the antimetabolites which include methotrexate, azathioprine, and mycophenolate mofetil; the calcineurin inhibitors which include cyclosporine, tacrolimus; alkylating agents which include cyclophosphamide and chlorambucil; and biologics which include the TNF-α inhibitors infliximab, adalimumab, and etanercept; daclizumab, interferon α2a, and rituximab. Take Home Message Newer agents are typically formulated from existing drugs or developed based on new advances in immunology. Future treatment will require a better understanding of the mechanisms involved in autoimmune diseases and better delivery systems in order to provide targeted treatment with minimal side effects.

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“…In a small retrospective case review of ten children with chronic uveitis (four patients with intermediate uveitis), low-dose methotrexate was shown to be effective and safe in controlling intraocular infl ammation for a mean of 22.5 months [ 65 ] (EBM 3, D).…”

Section: Core Messagesmentioning

confidence: 99%