Long-term results of therapy with mycophenolate mofetil in chronic non-infectious uveitis

Doycheva, Deshka; Zierhut, Manfred; Blumenstock, Gunnar; Stuebiger, Nicole; Deuter, Christoph

doi:10.1007/s00417-011-1731-8

Cited by 42 publications

(23 citation statements)

References 25 publications

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“…The average MMF dose in our study was 2.25 g/day (range 1-3 g/d), similar to other studies (20,22,24) . Most of the side effects in our series were observed with a dose of 3 g per day (three out of four patients).…”

Section: Side Effectssupporting

confidence: 90%

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Mycophenolate mofetil as an immunomodulator in refractory noninfectious uveitis

Rodriguez¹,

Sakata²,

Cavalcanti³

et al. 2016

Arquivos Brasileiros De Oftalmologia

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Section: Side Effectssupporting

confidence: 90%

“…This patient had favorable outcome after appropriate antibiotic therapy. inflammation with a prednisone dose of ≤10 mg per day after 1 or 2 years of MMF treatment (22) . Teoh found an 85% probability of reducing prednisone to ≤10 mg per day after one year of treatment (23) .…”

Section: Side Effectsmentioning

confidence: 99%

Mycophenolate mofetil as an immunomodulator in refractory noninfectious uveitis

Rodriguez¹,

Sakata²,

Cavalcanti³

et al. 2016

Arquivos Brasileiros De Oftalmologia

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“…42 Despite its limited experiences in practice of uveitis, this drug has gained considerable popularity, reflected by the emerging publications on its effectiveness in this particular field, 44,[97][98][99][100][101][102][103] as well as its second priority among uveitis specialists' current choices of immunosuppressive drugs in the United…”

Section: Mmfmentioning

confidence: 99%

Immunosuppressive Treatment of Non-infectious Uveitis: History and Current Choices

Zhao¹,

Zhang²

2017

cmsj

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Non-infectious uveitis is one of the leading causes of preventable blindness worldwide. Long-term immunosuppressive treatment is generally required to achieve durable control of inflammation in posterior and panuveitis. Although systemic corticosteroids have been the gold standard of immunosuppressive treatment for uveitis since first introduced in 1950s, its side effects of long-term use often warrant an adjuvant treatment to reduce the dosage/duration of corticosteroids needed to maintain disease control. Conventional immunosuppressive drugs, classified into alkylating agent, antimetabolites and T cell inhibitors, have been widely used as corticosteroid-sparing agents, each with characteristic safety/tolerance profiles on different uveitis entities. Recently, biologic agents, which target specific molecules in immunopathogenesis of uveitis, have gained great interest as alternative treatments for refractory uveitis based on their favorable safety and effectiveness in a variety of uveitis entities. However, lack of large randomized controlled clinical trials, concerns about efficacy and safety of long-term usage, and economic burden are limiting the use of biologics in non-infectious uveitis. Local administration of immunosuppressive drugs (from corticosteroids to biologics) through intraocular drug delivery systems represent another direction for drug development and is now under intense investigation, but more evidences are needed to support their use as regular alternative treatments for uveitis. With the numerous choices belonging to different treatment modalities (conventional immunosuppressive agents, biologics and local drug delivery systems) on hand, the practice patterns have been reported to vary greatly from center to center. Factors influence uveitis specialists' choices of immunosuppressive agents may be complex and may include personal familiarity, treatment availability, safety/tolerability, effectiveness, patient compliance, cost concerns and suggestions from related specialists such as rheumatologists and pediatricians. The focus of this review is to provide an overview of each treatment modality on safety/tolerability and effectiveness, which are believed to be the two most important factors affecting treatment decision making.

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“…MMF use in ocular inflammation was first explored in animal models of experimental autoimmune uveoretinitis (Chanaud et al 1995), leading to a number of studies supporting its use in refractory human inflammatory eye diseases, including noninfectious uveitis and scleritis (Kilmartin et al 1998b;Larkin and Lightman 1999;Sen et al 2003;Greiner et al 2002;Lau et al 2003;Baltatzis et al 2003;Siepman et al 2006;Thorne et al 2005;Teoh et al 2008). Doycheva and colleagues conducted a retrospective case series of 60 uveitis patients treated with MMF for at least 5 years and found that control of inflammation was achieved in 72% of patients after 1 year of treatment and in 82% after 2 years (Doycheva et al 2011). Rates of long-term side effects were similar to those reported in studies of short-term use (Siepman et al 2006;Thorne et al 2005).…”

Section: Mycophenolate Mofetilmentioning

confidence: 99%

“…Side effects associated with MMF most commonly include gastrointestinal upset, malaise, fatigue, headaches, and infection (Jabs et al 2000;Doycheva et al 2011). Bone marrow suppression and liver toxicities are less common but routine laboratory monitoring is essential and patients should limit alcohol consumption (Jabs et Knickelbein et al 2015).…”

Section: Mycophenolate Mofetilmentioning

confidence: 99%