Methotrexate for chronic non-necrotizing anterior scleritis in Chinese patients
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Chan Zhao and Mei-Fen Zhang. Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan, Dongcheng District, Beijing 100730, China. zhaochan@pumch.cn; meifen_zhang@hotmail.com

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

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    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.

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Jun-Yan Xiao, An-Yi Liang, Fei Gao, et al. Methotrexate for chronic non-necrotizing anterior scleritis in Chinese patients. Int J Ophthalmol, 2022,15(8):1261-1265

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Publication History
  • Received:February 21,2021
  • Revised:February 16,2022
  • Adopted:
  • Online: July 28,2022
  • Published: