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SQ Al-Khatib, EB Suhler, AR Djalilian, HN Sen, RB Nussenblatt, RR Buggage; The Use of Mycophenolate Mofetil for the Treatment of Non-Infectious Uveitis in Children . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4278.
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Purpose: The treatment of uveitis often requires the use of more than one immunosuppressive agent. The use of steroid sparing agents in the treatment of patients with uveitis helps to avoid the long term adverse effects of systemic steroids which can be detrimental, particularly in children. Mycophenolate mofetil (MMF) (Cellcept, Roche), an immunosuppressive drug, has recently been reported to be effective in the treatment of various forms of uveitis in adults either as monotherapy or in combination with other immunosuppressant drugs. We sought to determine if MMF was safe and useful for the treatment of uveitis in children. Methods: A retrospective, noncomparative review of the clinical records of all patients less than 18 years of age evaluated at the NEI and prescribed MMF for the treatment of uveitis was performed. Results: Four patients ages 10, 14, 15 and 16 diagnosed with Behcet's disease (2), idiopathic non-granulomatous anterior uveitis and idiopathic granulomatous panuveitis, respectively, were identified. The uveitis was unilateral in 2 patients including one patient who had undergone a previous enucleation. All patients were receiving prednisone when MMF was started. MMF was initiated as an additional immunosuppressant with methotexate (in 2 patients) and cyclosporine (in 2 patients) for uncontrolled ocular inflammation in two patients. The children were treated with 500 to 1500mg of MMF twice daily for periods ranging from 7-17 months (mean 13 months). One patient reported abdominal pain 3 months after increasing the dose of MMF from 1000 to 1500 mg twice a day that resolved when the dose was decreased. No patient had significant laboratory abnormalities. During treatment with MMF the frequency of ocular flares was lower in two patients and the dose of systemic steroids required to control the ocular inflammation was decreased for all patients except one. Methotrexate was discontinued in one patient. Conclusion: Based on this small series MMF appears to be a safe and well tolerated immunosuppressant for the treatment of uveitis in children.
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