Display options
Cite
Rivera-Grana E, Lin P, Suhler EB, et al. Methotrexate as a Corticosteroid-Sparing Agent for Thyroid Eye Disease. J Clin Exp Ophthalmol. 2015;6(2)doi: 10.4172/2155-9570.1000422.
Rivera-Grana, E., Lin, P., Suhler, E. B., & Rosenbaum, J. T. (2015). Methotrexate as a Corticosteroid-Sparing Agent for Thyroid Eye Disease. Journal of clinical & experimental ophthalmology, 6(2), . https://doi.org/10.4172/2155-9570.1000422
Rivera-Grana, Erick, et al. "Methotrexate as a Corticosteroid-Sparing Agent for Thyroid Eye Disease." Journal of clinical & experimental ophthalmology vol. 6,2 (2015). doi: https://doi.org/10.4172/2155-9570.1000422
Rivera-Grana E, Lin P, Suhler EB, Rosenbaum JT. Methotrexate as a Corticosteroid-Sparing Agent for Thyroid Eye Disease. J Clin Exp Ophthalmol. 2015 Apr;6(2). doi: 10.4172/2155-9570.1000422. Epub 2015 Apr 27. PMID: 26807304; PMCID: PMC4718577.
Copy Download .nbib Format: NLM
Share it on

J Clin Exp Ophthalmol. 2015 Apr;6(2). doi: 10.4172/2155-9570.1000422. Epub 2015 Apr 27.

Methotrexate as a Corticosteroid-Sparing Agent for Thyroid Eye Disease.

Journal of clinical & experimental ophthalmology

Erick Rivera-Grana, Phoebe Lin, Eric B Suhler, James T Rosenbaum

Affiliations

  1. Ponce Health Science University, Ponce, Puerto Rico.
  2. Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA.
  3. Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA; Portland VA Health Care System, Portland, Oregon, USA.
  4. Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA; Legacy Devers Eye Institute, Portland, Oregon, USA.

PMID: 26807304 PMCID: PMC4718577 DOI: 10.4172/2155-9570.1000422

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.

Keywords: Corticosteroids; Graves' disease; Immunosuppression; Methotrexate; Prednisone; Thyroid eye disease

References

  1. Clin Exp Ophthalmol. 2014 Nov;42(8):769-77 - PubMed
  2. J Ophthalmol. 2014;2014:128903 - PubMed
  3. Br J Ophthalmol. 2001 Oct;85(10):1220-4 - PubMed
  4. Cochrane Database Syst Rev. 2013 May 31;(5):CD009226 - PubMed
  5. Eur J Endocrinol. 2001 Apr;144(4):311-8 - PubMed
  6. Diabetes. 2015 Feb;64(2):360-9 - PubMed
  7. N Engl J Med. 2010 Feb 25;362(8):726-38 - PubMed
  8. J Clin Endocrinol Metab. 2014 Jun;99(6):1999-2007 - PubMed
  9. Hormones (Athens). 2002 Apr-Jun;1(2):76-90 - PubMed
  10. Int Ophthalmol Clin. 2013 Summer;53(3):93-101 - PubMed
  11. Endocr Rev. 1989 Aug;10(3):366-91 - PubMed
  12. Ophthalmology. 1984 Nov;91(11):1411-9 - PubMed
  13. Eur J Radiol. 2008 Jun;66(3):387-95 - PubMed
  14. J Clin Endocrinol Metab. 2015 Feb;100(2):432-41 - PubMed
  15. Eur J Nucl Med Mol Imaging. 2002 Aug;29 Suppl 2:S458-65 - PubMed

Publication Types

Grant support