Efficacy of mycophenolate mofetil in sarcoidosis.

Abstract

BACKGROUND:

Immunosuppressive (IS) therapy is indicated to treat progressive sarcoidosis, but randomized controlled trials to guide physicians in the use of steroid sparing agents are lacking. The aim of this retrospective study was to examine the role of mycophenolate mofetil (MMF) as an alternative therapy in the treatment of sarcoidosis.

METHODS:

A retrospective chart review of all patients who had been prescribed MMF between January 2008 and October 2011 was conducted. Patients with insufficient data or who had another IS therapy initiated concomitantly with MMF, including prednisone, were excluded. Physiological data obtained at the time MMF therapy was initiated as well as six and twelve months before and after therapy was extracted. Longitudinal analyses of the effect of MMF on changes in pulmonary function at MMF start, 6 months, 12 months pre and post MMF therapy were conducted.

RESULTS:

37/76 patients met our inclusion/exclusion criteria. There were no statistically significant changes in PFT measurements pre and post MMF therapy. We did find a trend (p = 0.07) towards improvement in DLCO 12 months pre and post MMF in patients who were started on MMF due to intolerance to previous IS therapy compared to those who were unresponsive to their previous IS therapy. We also noted a reduction in prednisone dose in those treated with MMF.

CONCLUSION:

MMF appears to offer no extra benefit to sarcoidosis patients unresponsive to previous steroid-sparing agents, but may be beneficial in patients intolerant to their previous steroid-sparing agent. Additional studies investigating the efficacy of MMF as the initial steroid-sparing agent are needed to further clarify the role of MMF in sarcoidosis.

• Authors: Nabeel Hamzeh, Allison Voelker, Anna Forssén, E Brigitte Gottschall, Cecile Rose, Peggy Mroz, Lisa A Maier
• Journal: Respiratory medicine (Respir Med) Vol. 108 Issue 11 Pg. 1663-9 (Nov 2014) ISSN: 1532-3064 [Electronic] England
• PMID: 25301291 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 Elsevier Ltd. All rights reserved.

Chemical References

• Glucocorticoids
• Immunosuppressive Agents
• Mycophenolic Acid
• Prednisone

Topics

• Adult
• Aged
• Drug Administration Schedule
• Drug Evaluation (methods)
• Drug Therapy, Combination
• Female
• Glucocorticoids (administration & dosage)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Male
• Middle Aged
• Mycophenolic Acid (analogs & derivatives, therapeutic use)
• Prednisone (administration & dosage)
• Pulmonary Diffusing Capacity (drug effects)
• Retrospective Studies
• Sarcoidosis, Pulmonary (drug therapy, physiopathology)
• Treatment Outcome
• Vital Capacity (drug effects)