Mycophenolate Mofetil Does Not Top MTX in Noninfectious Uveitis

For adults with noninfectious uveitis, mycophenolate mofetil is not associated with superior control of inflammation compared with methotrexate, according to a study published in the Sept. 10 issue of the Journal of the American Medical Association.

Sivakumar R. Rathinam, M.D., Ph.D., from Aravind Eye Hospitals and the Postgraduate Institute of Ophthalmology in Madurai, India, and colleagues compared the effect of methotrexate versus mycophenolate among patients with noninfectious uveitis requiring corticosteroid-sparing immunosuppressive therapy. Patients were randomly allocated to receive either oral methotrexate or oral mycophenolate mofetil (107 and 109 patients, respectively).

The researchers found that treatment success occurred in 66.7 and 57.1 percent of patients in the methotrexate and mycophenolate groups, respectively (odds ratio, 1.50; 95 percent confidence interval, 0.81 to 2.81; P = 0.20). Treatment success was achieved in 74.4 and 55.3 percent of patients with posterior uveitis or panuveitis in the methotrexate and mycophenolate groups, respectively (odds ratio, 2.35; 95 percent confidence interval, 1.16 to 4.90; P = 0.02), while among patients with intermediate uveitis, treatment success was achieved in 33.3 and 63.6 percent, respectively (odds ratio, 0.29; 95 percent confidence interval, 0.07 to 1.05; P = 0.07). The most common nonserious laboratory adverse event was elevated liver enzymes, occurring in 13.0 and 7.4 percent of patients in the methotrexate and mycophenolate groups, respectively.

"Further research is needed to determine if either drug is more effective based on the anatomical subtype of uveitis," the authors write.

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