Comparison of CD4 Counts with Mycophenolate Mofetil versus Methotrexate from the First-line Antimetabolites as Steroid-sparing Treatment (FAST) Uveitis Trial

Christina L. Kong; Nicole K. Kelly; Miel Sundararajan; S. R. Rathinam; John A. Gonzales; Radhika Thundikandy; Rajesh Vedhanayaki; Anuradha Kanakath; Bala Murugan; Thuy Doan; Debra Goldstein; Hassan A. Al-Dhibi; Nisha R. Acharya

doi:10.1080/09273948.2020.1774906

Comparison of CD4 Counts with Mycophenolate Mofetil versus Methotrexate from the First-line Antimetabolites as Steroid-sparing Treatment (FAST) Uveitis Trial

Christina L. Kong, Nicole K. Kelly, Miel Sundararajan, S. R. Rathinam, John A. Gonzales, Radhika Thundikandy, Rajesh Vedhanayaki, Anuradha Kanakath, Bala Murugan, Thuy Doan, Debra Goldstein, Hassan A. Al-Dhibi, Nisha R. Acharya^*

^*Corresponding author for this work

Ophthalmology

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Purpose: Sub-analysis of the FAST Trial comparing change in CD4 (∆CD4) from baseline through 12 months in uveitis patients treated with mycophenolate mofetil (MMF) and methotrexate (MTX). Methods: Patients were randomly allocated to 1.5 g twice daily MMF or 25 mg weekly MTX. Individuals with CD4 counts at baseline, 6 months (or treatment failure prior), and 12 months (or treatment failure between 6 and 12 months) were included. The association between treatment and ∆CD4 (cells/μL) was analyzed using multivariable linear regression. Results: There was no significant difference in ∆CD4 between MMF and MTX at 6 months (−31.7 cells/μL for MMF compared to MTX; 95% CI: −358.2 to 294.8, P = .85) and 12 months (−78.3 cells/μL for MMF compared to MTX; 95% CI: −468.0 to 311.3; P = .69). Conclusion: There was no significant difference in ∆CD4 between MMF and MTX from baseline to 12 months, suggesting that MMF does not confer additional risk of CD4 lymphopenia in uveitic patients. ClinicalTrials.gov Identifier: NCT 01829295.

Original language	English (US)
Pages (from-to)	198-202
Number of pages	5
Journal	Ocular Immunology and Inflammation
Volume	30
Issue number	1
DOIs	https://doi.org/10.1080/09273948.2020.1774906
State	Published - 2022

Funding

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. This study was funded by the National Eye Institute (NEI) (grant U10 EY021125). This work was supported by the National Eye Institute (NEI) under grant U10 EY021125 to Dr. Acharya. The Department of Ophthalmology at the University of California, San Francisco is supported by a core grant from the NEI (EY06190), an unrestricted grant from the Research to Prevent Blindness Foundation, and That Man May See Foundation.

Keywords

CD4
antimetabolite
methotrexate
mycophenolate mofetil
uveitis

ASJC Scopus subject areas

Immunology and Allergy
Ophthalmology

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10.1080/09273948.2020.1774906

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Kong, C. L., Kelly, N. K., Sundararajan, M., Rathinam, S. R., Gonzales, J. A., Thundikandy, R., Vedhanayaki, R., Kanakath, A., Murugan, B., Doan, T., Goldstein, D., Al-Dhibi, H. A., & Acharya, N. R. (2022). Comparison of CD4 Counts with Mycophenolate Mofetil versus Methotrexate from the First-line Antimetabolites as Steroid-sparing Treatment (FAST) Uveitis Trial. Ocular Immunology and Inflammation, 30(1), 198-202. https://doi.org/10.1080/09273948.2020.1774906

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title = "Comparison of CD4 Counts with Mycophenolate Mofetil versus Methotrexate from the First-line Antimetabolites as Steroid-sparing Treatment (FAST) Uveitis Trial",

abstract = "Purpose: Sub-analysis of the FAST Trial comparing change in CD4 (∆CD4) from baseline through 12 months in uveitis patients treated with mycophenolate mofetil (MMF) and methotrexate (MTX). Methods: Patients were randomly allocated to 1.5 g twice daily MMF or 25 mg weekly MTX. Individuals with CD4 counts at baseline, 6 months (or treatment failure prior), and 12 months (or treatment failure between 6 and 12 months) were included. The association between treatment and ∆CD4 (cells/μL) was analyzed using multivariable linear regression. Results: There was no significant difference in ∆CD4 between MMF and MTX at 6 months (−31.7 cells/μL for MMF compared to MTX; 95% CI: −358.2 to 294.8, P = .85) and 12 months (−78.3 cells/μL for MMF compared to MTX; 95% CI: −468.0 to 311.3; P = .69). Conclusion: There was no significant difference in ∆CD4 between MMF and MTX from baseline to 12 months, suggesting that MMF does not confer additional risk of CD4 lymphopenia in uveitic patients. ClinicalTrials.gov Identifier: NCT 01829295.",

keywords = "CD4, antimetabolite, methotrexate, mycophenolate mofetil, uveitis",

author = "Kong, {Christina L.} and Kelly, {Nicole K.} and Miel Sundararajan and Rathinam, {S. R.} and Gonzales, {John A.} and Radhika Thundikandy and Rajesh Vedhanayaki and Anuradha Kanakath and Bala Murugan and Thuy Doan and Debra Goldstein and Al-Dhibi, {Hassan A.} and Acharya, {Nisha R.}",

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year = "2022",

doi = "10.1080/09273948.2020.1774906",

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Kong, CL, Kelly, NK, Sundararajan, M, Rathinam, SR, Gonzales, JA, Thundikandy, R, Vedhanayaki, R, Kanakath, A, Murugan, B, Doan, T, Goldstein, D, Al-Dhibi, HA & Acharya, NR 2022, 'Comparison of CD4 Counts with Mycophenolate Mofetil versus Methotrexate from the First-line Antimetabolites as Steroid-sparing Treatment (FAST) Uveitis Trial', Ocular Immunology and Inflammation, vol. 30, no. 1, pp. 198-202. https://doi.org/10.1080/09273948.2020.1774906

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T1 - Comparison of CD4 Counts with Mycophenolate Mofetil versus Methotrexate from the First-line Antimetabolites as Steroid-sparing Treatment (FAST) Uveitis Trial

AU - Kong, Christina L.

AU - Kelly, Nicole K.

AU - Sundararajan, Miel

AU - Rathinam, S. R.

AU - Gonzales, John A.

AU - Thundikandy, Radhika

AU - Vedhanayaki, Rajesh

AU - Kanakath, Anuradha

AU - Murugan, Bala

AU - Doan, Thuy

AU - Goldstein, Debra

AU - Al-Dhibi, Hassan A.

AU - Acharya, Nisha R.

PY - 2022

Y1 - 2022

N2 - Purpose: Sub-analysis of the FAST Trial comparing change in CD4 (∆CD4) from baseline through 12 months in uveitis patients treated with mycophenolate mofetil (MMF) and methotrexate (MTX). Methods: Patients were randomly allocated to 1.5 g twice daily MMF or 25 mg weekly MTX. Individuals with CD4 counts at baseline, 6 months (or treatment failure prior), and 12 months (or treatment failure between 6 and 12 months) were included. The association between treatment and ∆CD4 (cells/μL) was analyzed using multivariable linear regression. Results: There was no significant difference in ∆CD4 between MMF and MTX at 6 months (−31.7 cells/μL for MMF compared to MTX; 95% CI: −358.2 to 294.8, P = .85) and 12 months (−78.3 cells/μL for MMF compared to MTX; 95% CI: −468.0 to 311.3; P = .69). Conclusion: There was no significant difference in ∆CD4 between MMF and MTX from baseline to 12 months, suggesting that MMF does not confer additional risk of CD4 lymphopenia in uveitic patients. ClinicalTrials.gov Identifier: NCT 01829295.

AB - Purpose: Sub-analysis of the FAST Trial comparing change in CD4 (∆CD4) from baseline through 12 months in uveitis patients treated with mycophenolate mofetil (MMF) and methotrexate (MTX). Methods: Patients were randomly allocated to 1.5 g twice daily MMF or 25 mg weekly MTX. Individuals with CD4 counts at baseline, 6 months (or treatment failure prior), and 12 months (or treatment failure between 6 and 12 months) were included. The association between treatment and ∆CD4 (cells/μL) was analyzed using multivariable linear regression. Results: There was no significant difference in ∆CD4 between MMF and MTX at 6 months (−31.7 cells/μL for MMF compared to MTX; 95% CI: −358.2 to 294.8, P = .85) and 12 months (−78.3 cells/μL for MMF compared to MTX; 95% CI: −468.0 to 311.3; P = .69). Conclusion: There was no significant difference in ∆CD4 between MMF and MTX from baseline to 12 months, suggesting that MMF does not confer additional risk of CD4 lymphopenia in uveitic patients. ClinicalTrials.gov Identifier: NCT 01829295.

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KW - antimetabolite

KW - methotrexate

KW - mycophenolate mofetil

KW - uveitis

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Comparison of CD4 Counts with Mycophenolate Mofetil versus Methotrexate from the First-line Antimetabolites as Steroid-sparing Treatment (FAST) Uveitis Trial

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