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Methotrexate as a Corticosteroid-Sparing Agent for Thyroid Eye Disease.
Erick Rivera-Grana1, Phoebe Lin2, Eric B Suhler3
1Ponce Health Science University, Ponce, Puerto Rico.
Journal of Clinical & Experimental Ophthalmology
|January 26, 2016
Summary
Methotrexate effectively reduced corticosteroid use in patients with Thyroid Eye Disease (TED). This steroid-sparing agent allowed 9 of 14 patients to discontinue prednisone, with some experiencing improved vision and eye movement.
Area of Science:
- Ophthalmology
- Endocrinology
- Rheumatology
Background:
- Thyroid Eye Disease (TED) management often relies on oral corticosteroids.
- A need exists for steroid-sparing agents to reduce corticosteroid-related side effects.
- Methotrexate is explored as a potential adjunct therapy.
Purpose of the Study:
- To evaluate the efficacy of methotrexate as a corticosteroid-sparing agent in patients with Thyroid Eye Disease.
- To assess the ability of methotrexate to facilitate prednisone discontinuation in TED patients.
Main Methods:
- Retrospective chart review of 14 TED patients from two eye inflammation clinics.
- Patients included were those unable to discontinue prednisone without disease recurrence.
- Methotrexate was administered orally (15 mg/week) or subcutaneously (20 mg/week).
Main Results:
- Nine out of 14 patients successfully discontinued prednisone completely after an average of 7.5 months on methotrexate.
- Five patients discontinued methotrexate due to lack of benefit or intolerance.
- Improved visual acuity was noted in 7 of 12 patients, and partial ocular motility improvement in 5 of 14 patients.
Conclusions:
- Methotrexate demonstrated a significant steroid-sparing effect in a subset of Thyroid Eye Disease patients.
- This suggests methotrexate can be a valuable option for managing TED and reducing corticosteroid dependence.
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