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2014 ; 108
(11
): 1663-9
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Efficacy of mycophenolate mofetil in sarcoidosis
#MMPMID25301291
Hamzeh N
; Voelker A
; Forssén A
; Gottschall EB
; Rose C
; Mroz P
; Maier LA
Respir Med
2014[Nov]; 108
(11
): 1663-9
PMID25301291
show ga
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.
|Adult
[MESH]
|Aged
[MESH]
|Drug Administration Schedule
[MESH]
|Drug Evaluation/methods
[MESH]
|Drug Therapy, Combination
[MESH]
|Female
[MESH]
|Glucocorticoids/administration & dosage
[MESH]
|Humans
[MESH]
|Immunosuppressive Agents/*therapeutic use
[MESH]
|Male
[MESH]
|Middle Aged
[MESH]
|Mycophenolic Acid/*analogs & derivatives/therapeutic use
[MESH]
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