Premium
Mycophenolate mofetil substitution for cyclosporine‐dependent myasthenia gravis and nephrotoxicity
Author(s) -
Lim A. K. H.,
Donnan G.,
Chambers B.,
Ierino F. L.
Publication year - 2007
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/j.1445-5994.2006.01222.x
Subject(s) - medicine , myasthenia gravis , mycophenolate , nephrotoxicity , immunosuppression , cyclophosphamide , immunosuppressive drug , gastroenterology , urology , transplantation , kidney , chemotherapy
Severe autoimmune myasthenia gravis is difficult to manage and may require immunosuppression with cyclosporine. However, cyclosporine dependency is associated with the risk of nephrotoxicity. Mycophenolate mofetil is a non‐nephrotoxic alternative which should be considered to rescue cyclosporine‐dependent, severe myasthenia gravis sufferers with renal impairment from progression to end‐stage renal failure. However, the evidence is limited and studies have not assessed the outcome of a direct substitution in these cyclosporine‐dependent patients. We study three such patients who successfully converted to mycophenolate mofetil, and briefly examine the evidence behind this option. We believe that total cyclosporine withdrawal is feasible, but strongly recommend overlapping mycophenolate mofetil treatment with cyclosporine.