Combined prednisone and mycophenolate mofetil treatment for retroperitoneal fibrosis: a case series.

Abstract

BACKGROUND:

Small case series suggest that a combination of mycophenolate mofetil and prednisone may be an effective treatment for patients with retroperitoneal fibrosis.

OBJECTIVE:

To describe the outcomes of adults with retroperitoneal fibrosis who received a combination of prednisone and mycophenolate mofetil.

DESIGN:

Prospective case series of patients followed between 1 April 2005 and 1 July 2009.

SETTING:

Single tertiary care facility.

PATIENTS:

28 patients with retroperitoneal fibrosis.

INTERVENTION:

Prednisone, 40 mg/d, tapered over 6 months, and mycophenolate mofetil, 1000 mg twice daily, for a mean of 24.3 months.

MEASUREMENTS:

Clinical course, laboratory assessment, and measurement of periaortic mass. Mean follow-up was 1012 days, and no patients were lost to follow-up.

RESULTS:

Systemic symptoms resolved in all patients; 89% had a 25% or greater reduction in periaortic mass. Elevated erythrocyte sedimentation rate and serum creatinine level and decreased hemoglobin level normalized in all patients. Disease recurred in 2 of 28 patients.

LIMITATION:

This was a small case series.

CONCLUSION:

Combined prednisone and mycophenolate mofetil therapy is a potentially effective treatment for retroperitoneal fibrosis that warrants evaluation in randomized trials.

PRIMARY FUNDING SOURCE:

None.

• Authors: Paul J Scheel Jr, Nancy Feeley, Stephen M Sozio
• Journal: Annals of internal medicine (Ann Intern Med) Vol. 154 Issue 1 Pg. 31-6 (Jan 04 2011) ISSN: 1539-3704 [Electronic] United States
• PMID: 21200036 (Publication Type: Journal Article)

Chemical References

• Anti-Inflammatory Agents
• Immunosuppressive Agents
• Mycophenolic Acid
• Prednisone

Topics

• Adult
• Aged
• Anti-Inflammatory Agents (therapeutic use)
• Drug Therapy, Combination
• Female
• Humans
• Immunosuppressive Agents (therapeutic use)
• Male
• Middle Aged
• Mycophenolic Acid (analogs & derivatives, therapeutic use)
• Prednisone (therapeutic use)
• Prospective Studies
• Retroperitoneal Fibrosis (diagnostic imaging, drug therapy)
• Tomography, X-Ray Computed
• Treatment Outcome