The following is a summary of “Methotrexate versus conventional disease-modifying antirheumatic drugs in the treatment of non-anterior sarcoidosis-associated uveitis,” published in the July 2024 issue of Ophthalmology by Leclercq et al.

Researchers conducted a retrospective study evaluating the safety and efficacy of methotrexate (MTX), mycophenolate mofetil (MMF), and azathioprine (AZA) for treating non-anterior sarcoidosis-related uveitis (NASRU).

They examined patients with uveitis, excluding individuals with anterior chamber involvement, following the criteria outlined in the revised International Workshop on Ocular Sarcoidosis. The main outcome was the median time for disease recurrence or the development of SAEs necessitating treatment discontinuation.

The result showed that 58 patients with NASRU received treatments like MTX (n=33), MMF (n=16), and AZA (n=9). The median time to treatment failure was significantly longer with MTX (34.5 months) compared to MMF (8.4 months) and AZA (16.8 months) (P=0.020). The relapse risk at 12 months was more than twice as low for MTX versus MMF (P=0.046). Low visual acuity at the last visit was lower with MTX (4%) compared to MMF (9%) and AZA (57%) (p=0.008). MTX also showed greater efficacy for treatment response at 3 months (OR 10.85; 95% CI 1.13 to 104.6; P=0.039) compared to all 75 lines of treatment (MTX (n=39), MMF (n=24) and AZA (n=12)), and significant corticosteroid-sparing effects at 12 months (P=0.035). SAEs occurred in 6/39 (15%) patients with MTX, 5/24 (21%) MMF, and in AZA 2/12 (17%).

Investigators concluded that MTX appears more effective than AZA and MMF in NARSU, demonstrating an acceptable safety profile.

Source: bjo.bmj.com/content/early/2024/07/16/bjo-2024-325163