gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Mycophenolate mofetil (MMF, CellCept®) is a highly effective and safe immunosuppressive agent for the treatment of uveitis

Meeting Abstract

  • corresponding author K. Siepmann - University Eye Hospital, Tübingen
  • M. Huber - University Eye Hospital, Tübingen
  • N. Stübiger - University Eye Hospital, Tübingen
  • C. Deuter - University Eye Hospital, Tübingen
  • M. Zierhut - University Eye Hospital, Tübingen

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogFR.16.10

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dog2004/04dog311.shtml

Veröffentlicht: 22. September 2004

© 2004 Siepmann et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

We evaluated the outcomes of patients with different forms of chronic uveitis treated with MMF as an immunomodulatory and steroid-sparing agent. The multi-system side effects that arise after long-term treatment with corticosteroids and other immunosuppressants prompted us to use MMF. MMF is a selective inhibitor of ionosine monophosphate dehydrogenase thus blocking purine synthesis via the de novo pathway preferentially used by T and B lymphocytes.

Methods

Between 1998 and 2003, 106 patients were treated for uveitis (anterior n=26, intermediate n=51, posterior n= 23, panuveitis n=6). Treatment duration was between 1 and 3 years. Patient charts were analysed according to a standardized evaluation protocol.

Results

In 95 patients MMF was combined with Prednisolone in a dosage of between 2.5 to 10 mg/day. In 8 patients MMF was used as a monotherapy and in 3 cases one further systemic immunosuppressant was required. The frequency of recurrences was 1 or less in 92 patients, 2 in 6 cases and 3 or greater in 8 patients. The most frequently observed side effects were gastrointestinal upset (15%, followed by eczema (9.3%), fatigue (5.7%), headache (5%), and hair loss (3.5%). Other side effects were sporadic. Most of these phenomena were transitory. Serum cholesterol and GPT were slightly raised in 5 patients requiring reduction of the therapeutic dosage of MMF. 42 patients experienced no side effects at all. In 4 patients MMF was judged ineffective due to recurrences or persistent macular edema. In 95 patients MMF was combined with Prednisolone in a dosage of between 2.5 to 10 mg/day. In 8 patients MMF was used as a monotherapy and in 3 cases one further systemic immunosuppressant was required. The frequency of recurrences was 1 or less in 92 patients, 2 in 6 cases and 3 or greater in 8 patients. The most frequently observed side effects were gastrointestinal upset (15%, followed by eczema (9.3%), fatigue (5.7%), headache (5%), and hair loss (3.5%). Other side effects were sporadic. Most of these phenomena were transitory. Serum cholesterol and GPT were slightly raised in 5 patients requiring reduction of the therapeutic dosage of MMF. 42 patients experienced no side effects at all. In 4 patients MMF was judged ineffective due to recurrences or persistent macular edema.

Conclusions

MMF is a safe, effective immunosuppressant in patients with uveitis. We provide evidence that MMF controls the disease in the majority of patients with an acceptable profile of side effects.