• Revista médica de Chile · Oct 2022

    [Off-label use of mycophenolate mofetil in immune-mediated diseases].

    • Alvaro Danza, Diego Graña, Cecilia Casas, Viviana Domínguez, and Martín Rebella.
    • Clínica Médica - Hospital Pasteur, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
    • Rev Med Chil. 2022 Oct 1; 150 (10): 131713241317-1324.

    BackgroundMycophenolate mofetil (MMF) is a largely used immunosuppressive agent in the prevention of transplant rejection and lupus nephritis. Its use has been extended to other immune-mediated diseases (ID).AimTo assess the off-label use of MMF, its performance as a glucocorticoid sparing agent, the therapeutic response, and its adverse effects.Material And MethodsA retrospective study was performed. One hundred-seven patients aged 58 ± 16 years (83% females) who received MMF for ID in off label uses between 2016 and 2018 were included. The study variables were cause of MMF indication, sex, age, use as a first- or second-line treatment and maintenance dosing. The cumulative doses of glucocorticoids six months before and after MMF indication were compared.ResultsMMF was used as a second-line therapy in 66 patients (62%). The mean maintenance dose of MMF was 1,500 ± 540 mg/day. Prednisone cumulative doses were 3,908 ± 2,173 and 1,672 ± 1,083 milligrams six months before and six months after starting MMF, respectively (p < 0.01). Adverse effects were identified in 21 (20%) cases, none of them serious.ConclusionsMycophenolate has a favorable response profile as a second line immunosuppressive agent. It is effective as a glucocorticoid sparing drug. The safety profile is also favorable as adverse effects were scanty and mild.

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