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- Title
Clinical and angiographic outcomes of mycophenolate versus methotrexate in South Asian patients of Takayasu arteritis: Results from an open-label, outcome-assessor blinded randomized controlled trial.
- Authors
Padiyar, Shivraj; Danda, Debashish; Goel, Ruchika; Joseph, Elizabeth; Nair, Aswin M; Joseph, George; Antonisamy, Belavendra
- Abstract
Objective: To compare the clinical and angiographic responses of mycophenolate mofetil (MMF) versus methotrexate (MTX) in Takayasu arteritis (TAK). Methods: This was an open-label, outcome assessor–blinded trial. Adult patients with active TAK were randomized 1:1 to MMF 1 g twice daily or MTX 20 mg once weekly by a computer-generated program. All patients were started on 0.5 mg/kg of steroids with a predetermined tapering protocol. The primary outcome was the treatment response as defined by Indian Takayasu arteritis score at 9 months. The secondary end points included the time to first failure and angiographic progression. Results: A total of 52 patients (26 in each arm) were recruited. The rate of responders was 71.43% (15/21) in the MMF arm and 63.64% (14/22) in the MTX arm (P = .58). The median time to the first failure was 9 months (range: 3–9) and 4.5 months (range: 3–9) in the MMF and MTX arms, respectively (P = .052). In both groups, 15% of patients (n = 3) had a progressive disease in angiography. Conclusions: The results showed numerically better outcomes favouring MMF, with a longer time to the first failure than MTX (9 months versus 4.5 months, P = .052). No significant difference was seen in the angiographic outcomes.
- Subjects
SOUTH Asians; TAKAYASU arteritis; RANDOMIZED controlled trials; METHOTREXATE; MYCOPHENOLIC acid
- Publication
Modern Rheumatology, 2024, Vol 34, Issue 1, p175
- ISSN
1439-7595
- Publication type
Article
- DOI
10.1093/mr/roac157