Methotrexate for chronic non-necrotizing anterior scleritis in Chinese patients  

作　　者：Jun-Yan Xiao An-Yi Liang Fei Gao Chan Zhao Mei-Fen Zhang 

机构地区：[1]Department of Ophthalmology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China [2]Department of Ophthalmology,Guangdong Provincial People’s Hospital,Guangdong Academy of Medical Sciences,Guangdong Eye Institute,Guangzhou 510080,Guangdong Province,China [3]Key Laboratory of Ocular Fundus Diseases,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China

出　　处：《International Journal of Ophthalmology(English edition)》2022年第8期1261-1265,共5页国际眼科杂志（英文版）

基　　金：Supported by The Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(No.2018PT32029)。

摘　　要：AIM:To evaluate the effectiveness and corticosteroidsparing 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 corticosteroidsparing 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.

关 键 词：METHOTREXATE non-necrotizing anterior scleritis pharmacotherapy corticosteroid-sparing Chinese population 

分 类 号：R772.32[医药卫生—眼科]