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Vol. 102, No. 3-4, 2006
Issue release date: February 2006
Section title: Original Paper
Nephron Clin Pract 2006;102:c100–c107
(DOI:10.1159/000089667)

Mycophenolate Mofetil in Anti-Neutrophil Cytoplasm Antibodies-Associated Systemic Vasculitis

Koukoulaki M. · Jayne D.R.W.
Vasculitis and Lupus Clinic, Addenbrooke’s Hospital, Cambridge, UK

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 3/15/2005
Accepted: 6/12/2005
Published online: 11/15/2005

Number of Print Pages: 1
Number of Figures: 3
Number of Tables: 4

ISSN: (Print)
eISSN: 1660-2110 (Online)

For additional information: http://www.karger.com/NEC

Abstract

Background: Mycophenolate mofetil (MMF) is an immune suppressive initially introduced for the prevention of solid organ allograft rejection that is increasingly used in autoimmune conditions, including vasculitis. Methods: This retrospective study evaluated the efficacy and tolerability of MMF in 51 sequential patients with anti-neutrophil cytoplasm antibodies-associated systemic vasculitis (AASV) treated in a single centre between 2001 and 2004. Results: The mean age was 54 years and median disease duration was 36 months. A mean of 3.5 systems were involved and the previous median exposure to cyclophosphamide was 9 g. MMF was administered either as remission maintenance therapy (29/51, 56.9%) or as treatment for active disease (22/51, 43.1%). The mean duration of MMF therapy was 20 months and the mean MMF dose during the first year was 1.6 g/day. 14/29 (48.3%) of those receiving MMF for remission maintenance therapy eventually relapsed with a mean time to relapse of 14 months. Of those receiving MMF for relapsing disease, 3 failed to respond to therapy while the rest achieved remission by 3.9 months. However, 9 of these subsequently flared; mean time to disease flare was also 14 months. MMF was withdrawn in 28 patients (54.9%) because of treatment inefficacy in 21, severe adverse events in 5 and intolerance in 2. Of the 51 treated, 36 (70.6%) experienced at least 1 side effect, namely infections in 24, gastrointestinal side effects in 12 and psychological events in 6 patients. Conclusions: We have observed varying efficacy of MMF in AASV, with over 50% of patients with relapsing disease achieving remission and marked falls in concomitant steroid doses. However, longer follow-up indicates a subsequent relapse rate of over 50% that may be associated with low MMF dosing.


  

Author Contacts

Dr. David R.W. Jayne
Vasculitis and Lupus Clinic
Box 118, Addenbrooke’s Hospital
Cambridge CB2 2QQ (UK)
Tel. +44 1223 217 259, Fax +44 1223 586 796, E-Mail dj106@cam.ac.uk

  

Article Information

Received: March 15, 2005
Accepted: June 12, 2005
Published online: November 10, 2005
Number of Print Pages : 8
Number of Figures : 3, Number of Tables : 4, Number of References : 24

  

Publication Details

Nephron Clinical Practice

Vol. 102, No. 3-4, Year 2006 (Cover Date: February 2006)

Journal Editor: Powis, S.H. (London)
ISSN: 1660–2110 (print), 1660–2110 (Online)

For additional information: http://www.karger.com/NEC


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 3/15/2005
Accepted: 6/12/2005
Published online: 11/15/2005

Number of Print Pages: 1
Number of Figures: 3
Number of Tables: 4

ISSN: (Print)
eISSN: 1660-2110 (Online)

For additional information: http://www.karger.com/NEC


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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