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- Title
Long-term results of therapy with mycophenolate mofetil in chronic non-infectious uveitis.
- Authors
Doycheva, Deshka; Zierhut, Manfred; Blumenstock, Gunnar; Stuebiger, Nicole; Deuter, Christoph
- Abstract
Background: Short-term studies have shown mycophenolate mofetil (MMF) to be a useful immunosuppressive agent for the treatment of intraocular inflammation. The aim of our study was to assess the long-term efficacy and tolerability of MMF in patients with chronic non-infectious uveitis, as well as to analyze disease course following discontinuation of therapy. Methods: This is a retrospective case series on 60 uveitis patients treated with MMF with a follow-up period of at least 5 years. The main outcome measures were: control of inflammation, corticosteroid-sparing potential, side-effects, ability to stop/taper MMF treatment because of effective control of inflammation and relapse rate after therapy discontinuation. Results: Control of intraocular inflammation (efficacy of MMF), defined as inactive disease under prednisolone dose of ≤10 mg daily, was achieved in 43 of 60 patients (72%) after 1 year of MMF treatment at a rate of 0.72 per patient-year (PY), and in 45 of 55 patients (82%) after 2 years therapy (rate: 0.41/PY). An improvement (3 lines) or stabilization of visual acuity was observed in 49 patients (82%), and a worsening in 11 patients (18%, 95% CI: 10-30%). The probability of discontinuing prednisolone, estimated by the Kaplan-Meier method, was 40% after 5 years therapy. The probability of discontinuing mycophenolate mofetil due to efficacy was 33% after 5 years treatment. Recurrences of uveitis occurred in six of 21 patients (29%, rate: 0.11/PY) after MMF discontinuation due to efficacy. The treatment was stopped because of inefficacy in 12 patients (rate: 0.05/PY) and because of side-effects in four patients (rate: 0.02/PY). The rate of adverse effects during MMF therapy was 0.17/PY. Conclusions: Our data show that mycophenolate mofetil is generally effective and well tolerated in the treatment of chronic non-infectious uveitis.
- Subjects
MYCOPHENOLIC acid; UVEITIS; IMMUNOSUPPRESSIVE agents; INFLAMMATION; DRUG efficacy; DRUG tolerance; ADRENOCORTICAL hormones
- Publication
Graefe's Archive of Clinical & Experimental Ophthalmology, 2011, Vol 249, Issue 8, p1235
- ISSN
0721-832X
- Publication type
Article
- DOI
10.1007/s00417-011-1731-8