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Jennifer M. Nottage, Kristin M. Hammersmith, Anthony Felipe, Irving Raber, Robert Penne, Azin Abazari, Ann Murchison; Treatment of Ocular Cicatricial Pemphigoid with Mycophenolate Mofetil. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4248.
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To evaluate the outcomes of treatment with mycophenolate mofetil (CellCept) for Ocular Cicatricial Pemphigoid (OCP).
Retrospective analysis of consecutive patients seen in OCP clinic at Wills Eye Institute, 1/1/04 to 12/31/09 treated primarily with mycophenolate mofetil(MM). Demographics and clinical characteristics, including dosage, treatment length, control of inflammation, and reason for discontinuation of therapy, were obtained by medical record review.
20 non-smoking OCP patients on MM were identified, 19 Caucasian and 1 African American. Average age was 73.3 years. 9/20 patients had biopsy proven OCP. All patients were at least Foster Grading System stage 2, with most stage 3 or 4. 8 patients failed previous treatments with dapsone, methotrexate, prednisione, azathioprine, or cyclophosphamide. 3 patients failed more than one immunosuppressive agent before treatment with MM. Average length of treatment was 19.66 months. 16/20 obtained complete suppression of inflammation while on the medication. Four patients failed MM and were changed to cyclophosphamide(2), azathioprime(1), or IVIG(1). One patient developed an allergy to MM and two patient required concomitant treatments with either prednisone or methotrexate. Only three patients developed side effects from MM: mild thrombocytopenia; gastric reflux; hypokalemia with muscle aches, insomnia, and anorexia.
In patients with OCP, treatment with mycophenolate mofetil offers disease suppression with a low side effect profile.
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