June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Mycophenolate Mofetil in Refractory Non-infectious Uveitis
Author Affiliations & Notes
  • Manoel Gusmao Isidro
    Hospital das Clinicas da Faculdade de Medicina da Universidade São Paulo, São Paulo, Brazil
  • Viviane Sakata
    Hospital das Clinicas da Faculdade de Medicina da Universidade São Paulo, São Paulo, Brazil
  • Daniel Cavalcanti
    Hospital das Clinicas da Faculdade de Medicina da Universidade São Paulo, São Paulo, Brazil
  • Juliana Zaghetto
    Hospital das Clinicas da Faculdade de Medicina da Universidade São Paulo, São Paulo, Brazil
  • Edilberto Olivalves
    Hospital das Clinicas da Faculdade de Medicina da Universidade São Paulo, São Paulo, Brazil
  • Carlos Hirata
    Hospital das Clinicas da Faculdade de Medicina da Universidade São Paulo, São Paulo, Brazil
  • Joyce Yamamoto
    Hospital das Clinicas da Faculdade de Medicina da Universidade São Paulo, São Paulo, Brazil
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 5392. doi:
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      Manoel Gusmao Isidro, Viviane Sakata, Daniel Cavalcanti, Juliana Zaghetto, Edilberto Olivalves, Carlos Hirata, Joyce Yamamoto; Mycophenolate Mofetil in Refractory Non-infectious Uveitis. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5392.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To evaluate the effectiveness of Mycophenolate Mofetil (MMF) as an immunossupressive agent for refractory non-infectious uveitis.

Methods: Data from patients with non-infectious uveitis, followed in the Uveitis Service, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil, under MMF (1-3g/day) oral therapy during 2007-2012 period were retrospectively analyzed. Treatment duration was at least 6 months. Patients were evaluated at 6 (T6) and 12 months (T12) after maximum dosage was achieved. Primary outcomes were success in gaining complete control of inflammation, success in maintaining control of inflammation after tapering of prednisone to ≤10mg/day (at least for 28 days) and discontinuation of treatment. Secondary outcomes were partial improvement in inflammation and use of other immunopressant after MMF therapy start. Clinical activity was evaluated according to SUN guidelines. Fluorescein angiography (FA) and optical coherence tomography (OCT) were analyzed when indicated. This study was approved by Institutional Ethics Committee Board (0621/11).

Results: Seventeen patients (Vogt-Koyanagi-Harada disease, 5; Behcet disease, 4; idiopathic retinal vasculitis, 3; intermediate uveitis, 3; HLA-B27 +ve ankylosing spondylitis,1; idiopathic diffuse uveitis,1) with a mean age of 40±15 years (14-59 y) were included. Nine patients (53%) were male. The mean duration of inflammation prior to achieving MMF maximum dosage was 85.9±73.6 mo (24-276mo). All patients at MMF start (T0) had previously taken other immunossupressant/biologic agent (cyclosporine, 14; azathioprine, 13; methotrexate,2; chlorambucil, 3; cyclophosphamide,2; infliximab, 2; adalimumab,2). Complete control of inflammation was achieved in 7 (41.2%) and in 6 patients (37,5%) at T6 and T12, respectively. Four out of 10 patients (40%), who were taking prednisone >10mg/d at T0, were succeeded in reducing prednisone to ≤10mg/d and in mantaining sustained inflammatory control during the follow up. One patient discontinued MMF due to side effects after 11mo. Partial control of inflammation was observed in 9 patients (52.9%) and in 8 patients (47.1%) at T6 and T12, respectively. 85% of those with complete control of inflammation had no additional immunossupressant at T6 and T12.

Conclusions: Our results show that MMF is an effective immunossupressant in patients with refractory non-infectious uveitis presenting few side effects.

Keywords: 746 uveitis-clinical/animal model • 555 immunomodulation/immunoregulation • 462 clinical (human) or epidemiologic studies: outcomes/complications  
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