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Deshka Doycheva, Christoph M. Deuter, Gunnar Blumenstock, Nicole Stuebiger, Manfred Zierhut; Long-term Results Of Therapy With Mycophenolate Mofetil In Ocular Mucous Membrane Pemphigoid. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4249.
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Only few studies report on mycophenolate mofetil (MMF) treatment in ocular mucous membrane pemphigoid (OcMMP). Our aim was to evaluate the long-term efficacy and side effects of MMF in the therapy of OcMMP.
Medical records of patients with ocular pemphigoid treated with MMF were retrospectively reviewed. Only patients with a follow-up period of at least 4 years were included in the study. The main outcome measures were conjunctival inflammation, progression of cicatrization, visual acuity and side effects.
Ten patients (19 eyes) were eligible for the study. No activity of inflammation under MMF dosage of 2g daily was found in 11 eyes (58%) of 6 patients, but reactivation of conjunctival inflammation after MMF dose reduction occurred in four eyes (21%). At least mild inflammatory activity under standard MMF dosage was observed in 8 eyes (42%) of 4 patients. Progression of conjunctival cicatrization was prevented in 47% (9/19) of the eyes. Mild progression of cicatrization was found in 42% (8/19) of the eyes. In one patient conjunctival cicatrization has progressed to stage IV in both eyes (11%). Visual acuity was maintained or improved in 58% (11/19) of the eyes. Treatment-related side effects occurred in 7 patients with a rate of 0.17 per patient-year (PY). MMF was discontinued in one patient because of gastrointestinal upset (rate: 0.02/PY).
Our data suggest that MMF is an effective immunosuppressive agent for the treatment of ocular mucous membrane pemphigoid. However, the drug can not always prevent the slow progression of conjcunctival cicatrization in this disease.
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