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Tacrolimus monotherapy may potentially reduce corticosteroid use in uveitis patients
Corticosteroid withdrawal is possible in some tacrolimus-treated patients who had noninfectious uveitis managed with prednisone daily, according to a study.
“This report provides the first prospective phase 2 [randomized controlled trial] evidence that corticosteroid withdrawal is a feasible goal in most patients treated with tacrolimus for sight-threatening [posterior segment intraocular inflammation],” the study authors said.
The open-label study involved 35 patients who were able to be tapered to 10-mg prednisone daily without reactivation of uveitis. They were then randomly assigned to take either a dual therapy of prednisone and tacrolimus or a monotherapy of tacrolimus. Patients who received the dual therapy began with 10-mg prednisone daily for 3 months, tapering to a minimum of 7.5 mg daily.
At 9 months, 62.5% of patients in the monotherapy group and 68.4% of patients in the dual-therapy group maintained remission of uveitis.
All monotherapy failures were due to disease reactivation, and 50% of dual-therapy failures were due to drug intolerance.
The difference in mean visual acuity change for the monotherapy group was less than one logMAR letter compared with the dual-therapy group.