June 2020
Volume 61, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2020
Comparison of CD4 counts with mycophenolate mofetil versus methotrexate from the First-line Antimetabolites as Steroid-sparing Treatment (FAST) Uveitis Trial
Author Affiliations & Notes
  • Christina Kong
    F.I. Proctor Foundation, University of California, San Francisco, San Francisco, California, United States
  • Nicole Kelly
    F.I. Proctor Foundation, University of California, San Francisco, San Francisco, California, United States
  • SR Rathinam
    Uvea Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Madurai, India
  • John Alexander Gonzales
    F.I. Proctor Foundation, University of California, San Francisco, San Francisco, California, United States
    Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States
  • Radhika Thundikandy
    Uvea Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Madurai, India
  • Anuradha Kanakath
    Uvea Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Coimbatore, India
  • Bala Murugan
    Uvea Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Pondicherry, India
  • Rajesh Vedhanayaki
    Uvea Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Madurai, India
  • Thuy Doan
    F.I. Proctor Foundation, University of California, San Francisco, San Francisco, California, United States
    Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States
  • Caleb Ebert
    F.I. Proctor Foundation, University of California, San Francisco, San Francisco, California, United States
  • Nisha Acharya
    F.I. Proctor Foundation, University of California, San Francisco, San Francisco, California, United States
    Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States
  • Footnotes
    Commercial Relationships   Christina Kong, None; Nicole Kelly, None; SR Rathinam, None; John Gonzales, None; Radhika Thundikandy, None; Anuradha Kanakath, None; Bala Murugan, None; Rajesh Vedhanayaki, None; Thuy Doan, None; Caleb Ebert, None; Nisha Acharya, None
  • Footnotes
    Support  NEI cooperative agreement U10 EY021125 (to Dr. Acharya, primary investigator). The Department of Ophthalmology at UCSF is supported by an unrestricted grant from the Research to Prevent Blindness Foundation, a core grant (EY06190) from the NEI, and That Man May See Foundation.
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 3667. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Christina Kong, Nicole Kelly, SR Rathinam, John Alexander Gonzales, Radhika Thundikandy, Anuradha Kanakath, Bala Murugan, Rajesh Vedhanayaki, Thuy Doan, Caleb Ebert, Nisha Acharya; Comparison of CD4 counts with mycophenolate mofetil versus methotrexate from the First-line Antimetabolites as Steroid-sparing Treatment (FAST) Uveitis Trial. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3667.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : Mycophenolate mofetil (MMF) can decrease CD4 counts by inhibiting an enzyme in GTP synthesis crucial for lymphocyte proliferation; however, it is unclear if MMF has a significant effect on CD4 counts that requires lab monitoring when treating uveitis for 6 months or longer. The FAST randomized control trial compared MMF and MTX as corticosteroid-sparing treatments for uveitis. We performed a sub-analysis to compare the change in CD4 counts between patients treated with MMF and MTX.

Methods : A subset of clinical sites obtained CD4 counts in the FAST Trial. Patients with CD4 counts at baseline, the primary endpoint (6-month visit or treatment failure (TF) before 6 months) and secondary endpoint (12-month visit or TF between 6-12 months) who did not change treatment (MMF or MTX) were included. Treatment was randomly allocated to either 1.5 g twice daily MMF or 25 mg weekly MTX. Change in CD4 count was measured from baseline to the primary/secondary endpoint and reported in cells/μL. The effect of treatment on change in CD4 count was analyzed using linear regression, adjusting for country, age, and sex.

Results : A total of 124 patients were included in the sub-analysis, with 62 patients per treatment arm. For patients on MMF, the mean baseline CD4 count was 1,020 cells/μL (95% CI: 785-1250) and the mean 6-month count was 1,040 cells/μL (95% CI: 870-1204) (Table 1). For patients on MTX, the mean baseline CD4 count was 960 cells/μL (95% CI: 796-1124) and mean 6-month count was 1,000 cells/μL (95% CI: 881-1125). There was no significant difference in the change in CD4 counts between MMF and MTX in the adjusted model at 6 months (-31.7 cells/μL for MMF compared to MTX; 95% CI: -358.2 to 294.8, P= 0.85). Of the 73 patients with a measurement at 12 months, there was no significant difference in the change in CD4 counts between MMF and MTX in the adjusted model at 12 months (-78.3 cells/μL for MMF compared to MTX; 95% CI: -468.0-311.3; P=0.69).

Conclusions : There was no significant difference between MMF and MTX when comparing the change in CD4 counts from baseline to 6 and 12 months, suggesting that MMF may not have a significant effect on CD4 counts when given orally as 1.5 g twice daily for up to one year.

This is a 2020 ARVO Annual Meeting abstract.

 

 

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×