Long-term efficacy of mycophenolate mofetil in the control of severe intraocular inflammation.

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
• Journal: Clinical & experimental ophthalmology (Clin Exp Ophthalmol) Vol. 31 Issue 6 Pg. 487-91 (Dec 2003) ISSN: 1442-6404 [Print] Australia
• PMID: 14641155 (Publication Type: Journal Article)

Chemical References

• Immunosuppressive Agents
• 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