title: High Efficacy of Methotrexate in Patients with Recurrent Idiopathic Acute Anterior Uveitis: a Prospective Study.
abstract: To evaluate prospectively the efficacy of methotrexate (MTX) in the treatment of recurrent idiopathic acute anterior uveitis (RIAAU). Nineteen out of 22 RIAAU patients completed the study (two patients withdrew their consent shortly after study initiation, one patient discontinued after 4 weeks because of the adverse effects). All patients were treated with MTX in a starting dose of 15 mg/week, increased to target dose of 25 mg/week after 4 weeks. In patients taking systemic corticosteroids (CS) the dose was gradually tapered (by 2.5 mg every week) until discontinuation. The mean follow-up period was 3.3 years (19-59 months). Sixteen patients (84 %) remained flare-free on MTX therapy. In the remaining three patients the mean interval between flares increased from 4.8 to 18.3 months. Systemic CS were tapered off in all patients. The number of acute anterior uveitis flares in the whole cohort decreased from 2.12 to 0.11/patient-year (p < 0.0001). All flares observed on MTX therapy occurred in HLA-B27-positive patients. MTX dosed at 25 mg/week is highly effective in the treatment of RIAAU.
authors.affiliation: Department of Internal Diseases and Rheumatology, Military Institute of Medicine, Warsaw, Poland. artur.bachta@gmail.com.
authors.forename: Artur
authors.initials: A
authors.lastname: Bachta
authors.affiliation: Department of Internal Diseases and Rheumatology, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Bartłomiej
authors.initials: B
authors.lastname: Kisiel
authors.affiliation: Department of Ophthalmology, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Mateusz
authors.initials: M
authors.lastname: Tłustochowicz
authors.affiliation: Department of Internal Diseases and Rheumatology, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Raczkiewicz
authors.affiliation: Department of Ophthalmology, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Rękas
authors.affiliation: Department of Internal Diseases and Rheumatology, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Witold
authors.initials: W
authors.lastname: Tłustochowicz
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D018501:Antirheumatic Agents; D005260:Female; D005500:Follow-Up Studies; D015796:HLA-B27 Antigen / Q000378:metabolism; D006801:Humans; D007166:Immunosuppressive Agents / Q000737:chemistry / Q000627:therapeutic use*; D007167:Immunotherapy / Q000379:methods; D007249:Inflammation; D008297:Male; D008727:Methotrexate / Q000737:chemistry / Q000627:therapeutic use*; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D013997:Time Factors; D014606:Uveitis, Anterior / Q000188:drug therapy*
chemical_list: D000305:Adrenal Cortex Hormones; D018501:Antirheumatic Agents; D015796:HLA-B27 Antigen; D007166:Immunosuppressive Agents; D008727:Methotrexate
keywords: Immunotherapy; Inflammation; Methotrexate; Uveitis