| Abstract | PURPOSE: To assess whether the previously demonstrated short-term efficacy of the immunosuppressant mycophenolate mofetil (MMF; CellCept, Roche) is maintained in the long-term management of refractory uveitis. METHODS: The study was an open-label, non-comparative retrospective series of 14 patients with refractory uveitis and treated with MMF for a mean of >33 months. Mycophenolate mofetil was given at a dosage of 1 g (oral) twice daily. Indications included prednisolone reduction, additive agent with cyclosporin, or replacement therapy (azathioprine or methotrexate). The intraocular inflammatory response, side-effects, and toxicity were monitored. RESULTS: Intraocular inflammation remained under control in 10 patients, unchanged in three and deteriorated in one patient. Transient side-effects included tiredness, headache and dizziness (one patient each, lasting less than 2 weeks from the time of MMF introduction). Mycophenolate mofetil was stopped in one patient because of absence of prolonged clinical improvement. Vision improved in 25% (7 eyes), did not change in 50% (14 eyes), but was reduced in 25% (7 eyes). CONCLUSIONS: Mycophenolate mofetil is safe for long-term usage and is recommended for treatment of refractory panuveitis or posterior uveitis with uncontrolled inflammation despite high prednisolone maintenance dosage (>15 mg/day) or toxicity or lack of efficacy of other immuno-suppressive agents. However, MMF is less effective for refractory uveitis unresponsive to azathioprine. |
| Authors | Chun H Lau, Marie Comer, Susan Lightman
(Affiliation: Department of Clinical Ophthalmology, Institute of Ophthalmology and Moorfields Eye Hospital, City Road, London EC1V 2PD, UK.)
|
| Journal | Clinical & experimental ophthalmology
(Clin Experiment Ophthalmol)
Vol. 31
Issue 6
Pg. 487-91
(Dec 2003)
ISSN: 1442-6404 Australia |
| PMID | 14641155
(Publication Type: Journal Article)
|
| Chemical References |
- Immunosuppressive Agents
- mycophenolate mofetil
- Mycophenolic Acid
|
| Topics |
- Adult
- Aged
- Female
- Follow-Up Studies
- Humans
- Immunosuppressive Agents
(adverse effects, therapeutic use)
- Male
- Middle Aged
- Mycophenolic Acid
(adverse effects, analogs & derivatives, therapeutic use)
- Retrospective Studies
- Safety
- Treatment Outcome
- Uveitis
(drug therapy, prevention & control)
- Visual Acuity
|
