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D. Doycheva, C. M. Deuter, N. Stuebiger, M. Zierhut; Mycophenolate Mofetil for Therapy of Non-Infectious Uveitis - 5 Years Results. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5259.
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In some short-term studies mycophenolate mofetil (MMF) was shown to be an effective immunosuppressive agent for treatment of intraocular inflammation. The aim of our study was to evaluate the long-term results of MMF therapy in patients with non-infectious uveitis.
Medical records of uveitis patients treated with MMF were retrospectively reviewed. Only patients with a follow-up period of at least 5 years were included in the study. The main outcome measures were steroid-sparing potential, discontinuation of MMF because of remission, change in visual acuity and long-term side effects.
A total of 60 uveitis patients with a follow-up time of 5 or more years after initiation of MMF treatment were evaluated. Thirty-seven percent of the patients had been treated previously with at least one other immunosuppressive drug. Treatment success of MMF as judged by ability to control intraocular inflammation and to taper prednisolone to < 7.5mg daily was achieved in 67% of the patients after 1 year and in 75% of the patients after 2 years treatment. Visual acuity was maintained or improved in 82% of the patients. MMF was discontinued in 21 patients (35%) due to remission. Recurrences of uveitis occurred in 6 patients after MMF discontinuation. Relapses of intraocular inflammation were observed in 11 of 23 patients (48%) during reduction of MMF. The MMF treatment was stopped because of insufficient control of inflammation or macular edema in 12 patients (20%) and because of side effects in 4 patients (6.7%) after at least 1 year of treatment.
MMF is an effective steroid-sparing agent in the therapy of uveitis. Our study shows that MMF can be stopped in one-third of the treated patients. The main cause of therapeutic failure of MMF was its inefficacy in treatment of chronic uveitic macular edema. In such cases other immunosuppressive or immunomodulatory agents should be considered.
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