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Long‐term efficacy of mycophenolate mofetil in the control of severe intraocular inflammation
Author(s) -
Lau Chun H,
Comer Marie,
Lightman Susan
Publication year - 2003
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1046/j.1442-9071.2003.00704.x
Subject(s) - medicine , azathioprine , mycophenolate , uveitis , mycophenolic acid , refractory (planetary science) , prednisolone , methotrexate , surgery , transplantation , ophthalmology , disease , physics , astrobiology
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 immunosuppressive agents. However, MMF is less effective for refractory uveitis unresponsive to azathioprine.