CellCept (mycophenolate mofetil, Roche), an immunosuppressive drug used to prevent organ transplant rejection, may also be used to treat patients who have inflammatory eye diseases, according to a study in the August issue of Ophthalmology.
Researchers at Johns Hopkins Wilmer Eye Institute recruited 84 patients who had noninfectious inflammatory eye disease: 61% had uveitis, 17% had scleritis, 11% had mucous membrane pemphigoid, and 11% had orbital or another inflammatory eye disease.
Patients took a total of 2g of mycophenolate mofetil a day. The drug was the primary immunosuppressive for 72 patients, and it was added to another immunosuppressive agent in the remaining 12 patients. A total of 89% of patients were taking prednisone at the start of mycophenolate treatment.
Results showed that 97% of patients achieved control of their ocular inflammation after one month of treatment. In addition, 82% achieved inflammation control and were able to decrease their prednisone to 10mg or less a day. Seven patients stopped taking the drug due to gastrointestinal upset.
So, could mycophenolate replace corticosteroid therapy in the treatment of inflammatory eye disease? That would be a good outcome, but its too soon to tell, says Jennifer Thorne, M.D., one of the studys authors and assistant professor of ophthalmology at Wilmer Eye Institute.
Practitioners who specialize in treating chronic ocular inflammation are definitely interested in using immunosuppressive therapy to avoid the corticosteroid-related side effects from long-term use, she says. In our study, however, patients who used mycophenolate mofetil were not followed for an extended period of time, so it is unclear if patients can achieve long-term suppression of ocular inflammation by using this drug alone. Also, there are other similar medications known to suppress inflammation, such as methotrexate and azathioprine. Further studies comparing these drugs are needed to determine the true effectiveness of mycophenolate mofetil.
Thorne JE, Jabs DA, Qazi FA, Nguyen QD, et al. Mycophenolate mofetil therapy for inflammatory eye disease. Ophthalmology 2005 Aug;112(8):1472-7.