Methotrexate As a Corticosteroid-Sparing Agent for Thyroid Eye Disease

Overview

Journal J Clin Exp Ophthalmol

Date 2016 Jan 26

PMID 26807304

Citations 9

Authors

Erick Rivera-Grana

Phoebe Lin

Eric B Suhler

James T Rosenbaum

Affiliations

Soon will be listed here.

Abstract

Objective: Thyroid eye disease (TED) is generally treated with oral corticosteroid therapy. A steroid sparing drug could be a useful adjunct. We reviewed our experience with methotrexate as a corticosteroid sparing agent to treat TED.

Methods: Retrospective chart review from two eye inflammation clinics. Patients with TED who were unable to discontinue prednisone therapy without disease recurrence were included.

Results: 14 patients who were receiving an average of 32 mg/day of prednisone were treated with methotrexate, usually 15 mg/week orally or 20 mg/week subcutaneously. Five patients discontinued therapy for a lack of benefit or intolerance. Of the 9 patients who remained on methotrexate, all were able to discontinue prednisone completely after an average duration of 7.5 months. Improved visual acuity by at least two lines on the Snellen chart was achieved by 7 of 12 patients with reduced acuity and partial improvement in ocular motility was achieved in 5 of 14 patients.

Conclusions: Methotrexate provided an effective steroid sparing effect in a subset of patients with TED.

Citing Articles

A Comprehensive Review of Thyroid Eye Disease Pathogenesis: From Immune Dysregulations to Novel Diagnostic and Therapeutic Approaches.

Kulbay M, Tanya S, Tuli N, Dahoud J, Dahoud A, Alsaleh F Int J Mol Sci. 2024; 25(21).

PMID: 39519180 PMC: 11546489. DOI: 10.3390/ijms252111628.

The changing landscape of thyroid eye disease: current clinical advances and future outlook.

Moledina M, Damato E, Lee V Eye (Lond). 2024; 38(8):1425-1437.

PMID: 38374366 PMC: 11126416. DOI: 10.1038/s41433-024-02967-9.

Periocular methotrexate versus periocular triamcinolone injections for active thyroid-associated orbitopathy: a randomized clinical trial.

Swaify I, Nasr H, El Essawy R, Elessawy K Jpn J Ophthalmol. 2023; 67(6):699-710.

PMID: 37540324 DOI: 10.1007/s10384-023-01016-4.

Updates on the understanding and management of thyroid eye disease.

Men C, Kossler A, Wester S Ther Adv Ophthalmol. 2021; 13:25158414211027760.

PMID: 34263138 PMC: 8252358. DOI: 10.1177/25158414211027760.

Risk of Chronic Obstructive Pulmonary Disease Exacerbation in Patients Who Use Methotrexate-A Nationwide Study of 58,580 Outpatients.

Bergsoe C, Sivapalan P, Saeed M, Eklof J, Saghir Z, Sorensen R Biomedicines. 2021; 9(6).

PMID: 34073252 PMC: 8229017. DOI: 10.3390/biomedicines9060604.

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