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M. Zierhut, M. Huber, N. Stuebiger, C. Deuter, K. Siepmann; Mycophenolate mofetil (MMF) is a highly effective and safe immunosuppressive agent for the treatment of uveitis . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3371.
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Purpose: We evaluated the outcomes of patients with different forms of chronic uveitis treated with MMF as an immunomodulatory and steroid–sparing agent. The multi–system side effects that arise after long–term treatment with corticosteroids and other immunosuppressants prompted us to use MMF. MMF is a selective inhibitor of inosine monophosphate dehydrogenase thus blocking purine synthesis via the de novo pathway preferentially used by T and B lymphocytes. Methods: Between 1998 and 2003, 106 patients were treated for uveitis (anterior n=26, intermediate n=51, posterior n= 23, panuveitis n=6). Treatment duration was between 1 and 3 years. Patient charts were analysed according to a standardized evaluation protocol. Results: In 95 patients MMF was combined with Prednisolone in a dosage of between 2.5 to 10 mg/day. In 8 patients MMF was used as a monotherapy and in 3 cases one further systemic immunosuppressant was required. The frequency of recurrences was 1 or less in 92 patients, 2 in 6 cases and 3 or greater in 8 patients. The most frequently observed side effects were gastrointestinal upset (15%), followed by eczema (9.3%), fatigue (5.7%), headache (5%), and hair loss (3.5%). Other side effects were sporadic. Most of these phenomena were transitory. 42 patients experienced no side effects at all. In 4 patients MMF was judged ineffective due to recurrences or persistent macular edema. Conclusions: MMF is a safe, effective immunosuppressant in patients with uveitis. We provide evidence that MMF controls the disease in the majority of patients with an acceptable profile of side effects.
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