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

Autor:	Fernández Zamora Y; Department of Ophthalmology and Visual Science, Escola Paulista de Medicina (EPM), Federal University of São Paulo (UNIFESP), São Paulo, Brazil., Marinho PM; Department of Ophthalmology and Visual Science, Escola Paulista de Medicina (EPM), Federal University of São Paulo (UNIFESP), São Paulo, Brazil.; Department of Ophthalmology, IPEPO - Vision Institute, São Paulo, Brazil., Dias JRO; Department of Ophthalmology and Visual Science, Escola Paulista de Medicina (EPM), Federal University of São Paulo (UNIFESP), São Paulo, Brazil., Cabral T; Department of Ophthalmology, IPEPO - Vision Institute, São Paulo, Brazil.; Department of Ophthalmology, Federal University of Espírito Santo, Vitória, Brazil., Casoy J; R&D Department, Newtown Consultancy, USA., Muccioli C; Department of Ophthalmology and Visual Science, Escola Paulista de Medicina (EPM), Federal University of São Paulo (UNIFESP), São Paulo, Brazil., Nascimento H; Department of Ophthalmology and Visual Science, Escola Paulista de Medicina (EPM), Federal University of São Paulo (UNIFESP), São Paulo, Brazil.; Department of Ophthalmology, IPEPO - Vision Institute, São Paulo, Brazil., Belfort R Jr; Department of Ophthalmology and Visual Science, Escola Paulista de Medicina (EPM), Federal University of São Paulo (UNIFESP), São Paulo, Brazil.; Department of Ophthalmology, IPEPO - Vision Institute, São Paulo, Brazil.
Jazyk:	angličtina
Zdroj:	Ocular immunology and inflammation [Ocul Immunol Inflamm] 2024 Nov; Vol. 32 (9), pp. 2068-2073. Date of Electronic Publication: 2024 Mar 05.
DOI:	10.1080/09273948.2024.2321270
Abstrakt:	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.
Databáze:	MEDLINE
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