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Abstracts of the 8th Meeting of the Italian Peripheral Nerve Study Group: 30
Author(s) -
Benedetti L,
Grandis M,
Nobbio L,
Mancardi GL,
Caponnetto C,
Primavera A,
Beronio A,
Ghiglione E,
Manzino M,
Sche A
Publication year - 2003
Publication title -
journal of the peripheral nervous system
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1
H-Index - 67
eISSN - 1529-8027
pISSN - 1085-9489
DOI - 10.1046/j.1529-8027.2003.00030.x
Subject(s) - multifocal motor neuropathy , medicine , mismatch negativity , myasthenia gravis , adverse effect , mycophenolic acid , clinical trial , peripheral neuropathy , disease , randomized controlled trial , surgery , transplantation , diabetes mellitus , electroencephalography , psychiatry , endocrinology
Mycophenolate mofetil (MM) is a new generation immunosuppressant, which has been successfully used for treatment of renal, heart and liver transplants, and other immune‐mediated diseases. MM is also a safe and steroid‐sparing agent for treating neuromuscular diseases, like chronic inflammatory demyelinating neuropathy and myastenia gravis. MM is an ester of mycophenolic acid, an agent that inhibits the proliferation of B and T lymphocytes. Side effects are modest and there is a lower risk for late malignancies than other immunosuppressive drugs. We assessed MM in the treatment of multifocal motor neuropathy (MMN). The therapy of MMN largely depends upon the use of intravenous immunoglobulins (IVIg). IVIg induce and maintain improvement in MMN, but they do not eradicate the disease and are very expensive. No randomized controlled trials are available to indicate whether immunosuppressive agents are beneficial in MMN. We treated with MM four patients who fulfilled the clinical, laboratory and electrodiagnostic criteria for MMN, aiming to assess whether the drug is safe and may help in reducing or discontinuing IVIg infusion in this disease. MM administration, at 1 g twice daily, was started when patients were still under IVIg treatment and showed minimal or no disability, as judged by the INCAT disability scale. At the third month of MM therapy, IVIg infusion was discontinued in 2 patients and reduced by 20 % in 2 patients. After a follow up ranging from 1 to 6 months, no worsening in the INCAT disability scale was observed in all the patients. One patient discontinued the medication after four months because of gastrointestinal discomfort with diarrhea, weight loss and increased amylase/lipase levels. The promising response to MM and the lack of major side effects, warrant further multicentric controlled trials in MMN.