Comparison Of Cd4 Counts With Mycophenolate Mofetil Versus Methotrexate From The First-Line Antimetabolites As Steroid-Sparing Treatment (Fast) Uveitis Trial

Purpose Sub-analysis of the FAST Trial comparing change in CD4 ( increment 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 increment CD4 (cells/mu L) was analyzed using multivariable linear regression. Results There was no significant difference in increment CD4 between MMF and MTX at 6 months (-31.7 cells/mu L for MMF compared to MTX; 95% CI: -358.2 to 294.8,P= .85) and 12 months (-78.3 cells/mu L for MMF compared to MTX; 95% CI: -468.0 to 311.3;P= .69). Conclusion There was no significant difference in increment 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