Long-Term Low-Dose Pyrimethamine Use for the Prevention of Ocular Toxoplasmosis Recurrences: A Cohort Study.

IF 2.6 4区医学 Q2 OPHTHALMOLOGY

Ocular Immunology and Inflammation Pub Date : 2024-11-01 Epub Date: 2024-03-05 DOI:10.1080/09273948.2024.2321270

Yuslay Fernández Zamora, Paula M Marinho, João Rafael Oliveira Dias, Thiago Cabral, Julio Casoy, Cristina Muccioli, Heloisa Nascimento, Rubens Belfort

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Abstract

Purpose: To describe the effect of long-term, low-dose pyrimethamine for the prevention of ocular toxoplasmosis (OT) recurrences.

Methods: Sixty-three consecutive patients with inactive ocular toxoplasmosis and positive toxoplasma IgG serology were included. Pyrimethamine (25 mg) + folinic acid (15 mg) were administered every other day (three times weekly) for 12 months. Eighteen patients received the treatment for an additional six months as part of an extension study.

Results: Thirty-eight patients (60.3%, n = 63) were female; 38 (60.3%) had a previous history of recurrence and 37 (58.7%) had active OT within the preceding 12 months. Three (4.8%) patients had unilateral recurrences at 8, 12 and 18 months after starting intermittent pyrimethamine treatment. Five patients (7.9%) were discontinued due to hematological, renal and hepatic changes. Treatment was considered successful in 42 patients (84%).

Conclusion: Long-term, low-dose pyrimethamine can be considered as a treatment option for the prevention of ocular toxoplasmosis recurrence in selected patients, with only a few, mild and reversible systemic adverse events.

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长期使用小剂量嘧霉胺预防眼弓形虫病复发：队列研究。

目的：描述长期小剂量嘧霉胺预防眼弓形虫病（OT）复发的效果：方法：连续纳入63例非活动性眼弓形虫病和弓形虫IgG血清学阳性的患者。嘧啶（25 毫克）+ 亚叶酸（15 毫克）隔天服用一次（每周三次），持续 12 个月。作为延伸研究的一部分，18 名患者又接受了 6 个月的治疗：38名患者（60.3%，n = 63）为女性；38名患者（60.3%）曾有复发病史，37名患者（58.7%）在之前的12个月内有活动性OT。3名患者（4.8%）在开始间歇性乙胺嘧啶治疗8、12和18个月后单侧复发。五名患者（7.9%）因血液学、肾脏和肝脏病变而停止治疗。42名患者（84%）的治疗被认为是成功的：结论：长期、小剂量嘧霉胺可作为预防眼弓形虫病复发的一种治疗选择，在选定的患者中仅有少数轻微、可逆的全身不良反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ocular Immunology and Inflammation 医学-眼科学

CiteScore

6.20

自引率

15.20%

发文量

285

审稿时长

6-12 weeks

期刊介绍： Ocular Immunology & Inflammation ranks 18 out of 59 in the Ophthalmology Category.Ocular Immunology and Inflammation is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and vision scientists. Published bimonthly, the journal provides an international medium for basic and clinical research reports on the ocular inflammatory response and its control by the immune system. The journal publishes original research papers, case reports, reviews, letters to the editor, meeting abstracts, and invited editorials.