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M. Shaikh, P. Y. Chang, C. Foster; Outcomes of Mycophenolate Mofetil as a Monotherapy in Pediatric Uveitis. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5863.
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To ascertain the outcomes of mycophenolate mofetil (MMF) as monotherapy in the treatment of pediatric uveitis.
This is a single-center, retrospective interventional case series. The charts of 61 pediatric patients with noninfectious uveitis treated with MMF at or before 18 years of age were reviewed. Primary outcome measures were 1) If another IMT was required (either to replace Cellcept or in addition to Cellcept) 2) Cellcept discontinued due to adverse effects 3) Successful discontinuation of Cellcept due to durable steroid-free remission 4) Continued Cellcept therapy at the time of data collection; visual acuity was a secondary outcome measure.
Seven of the 61 patients (11.5%) remained free of inflammation on MMF monotherapy. The need for additional IMT to either replace or to supplement Cellcept was at the rate of 0.14/PY. Of those patients, twelve (52.2%) continued Cellcept therapy, while eleven (47.8%) had to stop Cellcept therapy and were placed on another IMT, as Cellcept failed to contribute to remission. Adverse events were reported at the rate of 0.11/PY. The most common adverse effect reported was gastrointestinal disturbance (11.5%), leukopenia (6%) and fatigue (3.3%). Three of the patients had to stop Cellcept due to the adverse effects. Fifteen of the patients (24.6%) continued Cellcept therapy by the time data collection ended. One of the patients (1.6%) was lost to follow up. BCVA was unchanged in 23 of the patients (37.7%), of which 15 (65.2%) had a vision of 20/20. Twenty three patients (37.7%) had an improvement in their vision while thirteen of the patients had a worsening of their vision on Snellen testing.
Mycophenolate therapy was not very effective in putting children into remission as monotherapy. While effective in adult uveitis patients it was not very successful in inducing long-term disease remission in children.
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