Elsevier

Ophthalmology

Volume 106, Issue 2, 1 February 1999, Pages 370-374
Ophthalmology

Mycophenolate mofetil: A useful immunosuppressive in inflammatory eye disease

Presented as a poster at the first American Uveitis Society meeting, Breckenridge, Colorado, January 1997.
https://doi.org/10.1016/S0161-6420(99)90078-7Get rights and content

Abstract

Objective

To assess the usefulness of mycophenolate mofetil (MMF) (Cellcept, Roche), a potent selective uncompetitive and reversible inhibitor of ionisine monophosphate dehydrogenase involved in purine synthesis, as an immunosuppressive and steroid-sparing agent in the management of ocular inflammatory disease.

Design

Open-label, prospective, uncontrolled pilot study.

Participants

Eleven patients with uncontrolled ocular inflammation.

Intervention

Mycophenolate mofetil, at a dosage of 1 g twice daily, was given in conjunction with steroids, as a steroid-sparing agent, or as an additional agent with cyclosporine (CsA), or instead of CsA or azathioprine.

Main outcome measures

The inflammatory response, side effects, and toxicity were monitored.

Results

The addition of MMF to immunosuppressive regimens led to the improvement in symptoms and the ability to reduce the dose of prednisone in most patients. Ten of 11 patients showed a favorable response to MMF, with few side effects noted.

Conclusion

These findings suggest that MMF is a useful immunosuppressive drug for controlling ocular inflammation with minimal side effects.

Section snippets

Patients and methods

All patients with uveitis treated with MMF at Moorfields Eye Hospital were assessed for treatment outcome and adverse effects while receiving the drug. Mycophenolate mofetil was used as a third agent in patients who responded inadequately to steroids used concomitantly with cyclosporine (CsA) or was substituted for azathioprine as a second- or third-line drug. Mycophenolate mofetil was used also as a steroid-sparing agent in patients whose steroid dose could not be reduced to an acceptable

Results

In total, 11 patients received MMF. Table 1, Table 2 outline their demographics, diagnoses, treatment regimens before and after starting MMF, and duration of treatment with MMF. The types of inflammation were divided into two categories on the basis of the part of the eye affected: (I) panuveitis (Table 1) and (II) scleritis (Table 2). There were seven patients in group I. Five of these patients (patients, 2, 3, 4, 6, and 7) did exceptionally well without significant side effects. In all five,

Discussion

Mycophenolate mofetil, formerly known as RS-61443, is a fermentation product of several Penicillium species and the ester product of MPA.14 After oral administration, MMF is absorbed within 30 minutes and broken down in the liver to MPA, its metabolically active form.6 Mycophenolate mofetil is not generally detectable in plasma, and its bioavailability is approximately 94% with respect to MPA.6 Antacids given simultaneously may interfere with the absorption of MMF, and it is therefore suggested

References (21)

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