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

Research output: Contribution to journalArticle

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 languageEnglish (US)
JournalOcular Immunology and Inflammation
DOIs
StateAccepted/In press - 2020

Keywords

  • CD4
  • antimetabolite
  • methotrexate
  • mycophenolate mofetil
  • uveitis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Ophthalmology

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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. (Accepted/In press). 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. https://doi.org/10.1080/09273948.2020.1774906