Outcomes of Immunomodulatory Therapy With Mycophenolate Mofetil in Patients With Severe Ocular Inflammation

Abstract

Abstract: : Purpose:To assess the efficacy and safety of the Immunomodulatory agent mycophenolate mofetil (MMF; CellCept, Roche) in a large number of patients with severe ocular inflammation. Methods: The study was an open–label, interventional, non–comparative retrospective series of 41 patients with refractory uveitis and or scleritis, with an average follow–up of 26.8 months, treated with MMF for an average period of 13.3 months ( range 3–59 months). After IRB approval, data including the intraocular inflammatory response, side–effects, and toxicity were examined. Primary outcome measures were control of intraocular inflammation and tolerability of MMF. Results:Refractory disease with or without another factor was the major indication for starting MMF, followed by steroid–sparing effect, toxicity of previous agents. MMF was effective in controlling intraocular inflammation either alone or in combination with another agent in 25 patients (60.9%) and ineffective in 9 (22.0%) . MMF had to be stopped in 7 patients due to intolerance. However, none of these patients developed any permanent systemic morbidity on follow–up. Of 74 seeing eyes, vision was maintained or improved in 60 (81.1%) patients. Conclusions: MMF is a useful alternative immunosuppressive agent for patients with recalcitrant ocular inflammation. Side effects are generally well tolerated or avoidable.

Keywords: inflammation • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled • immunomodulation/immunoregulation