Mycophenolate Mofetil for Ocular Inflammation

Ebenezer Daniel, Jennifer E. Thorne, Craig W. Newcomb, Siddharth S. Pujari, R. Oktay Kaçmaz, Grace A. Levy-Clarke, Robert B. Nussenblatt, James (Jim) Rosenbaum, Eric Suhler, C. Stephen Foster, Douglas A. Jabs, John H. Kempen

Research output: Contribution to journalArticle

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Abstract

Purpose: To evaluate mycophenolate mofetil as a single noncorticosteroid immunosuppressive treatment for noninfectious ocular inflammatory diseases. Design: Retrospective cohort study. Methods: Characteristics of patients with noninfectious ocular inflammation treated with mycophenolate mofetil at 4 subspecialty clinics from 1995 to 2007 were abstracted by expert reviewers in a standardized chart review of every eye at every visit. Main outcomes measured were control of inflammation, corticosteroid-sparing effects, and discontinuation of mycophenolate mofetil (including the reasons for discontinuation). Survival analysis was used to estimate the incidence of outcomes, and to identify risk factors for each. Results: Among 236 patients (397 eyes) treated with mycophenolate mofetil monotherapy, 20.3%, 11.9%, and 39.8% had anterior uveitis, intermediate uveitis, and posterior uveitis or panuveitis respectively; 14% had scleritis; 7.6% had mucous membrane pemphigoid; and 6.4% had other ocular inflammatory diseases. By Kaplan-Meier estimation, complete control of inflammation-sustained over consecutive visits spanning at least 28 days-was achieved in 53% and 73% of patients within 6 months and 1 year respectively. Systemic corticosteroid dosage was reduced to 10 mg of prednisone or less, while maintaining sustained control of inflammation, in 41% and 55% of patients in 6 months and 1 year respectively. Twelve percent of patients discontinued mycophenolate mofetil within the first year because of side effects of therapy. Conclusions: Given sufficient time, mycophenolate mofetil was effective in managing ocular inflammation in approximately half of the treated patients. Treatment-limiting side effects were observed in 12% of patients and typically were reversible.

Original languageEnglish (US)
JournalAmerican Journal of Ophthalmology
Volume149
Issue number3
DOIs
StatePublished - Mar 2010

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Mycophenolic Acid
Inflammation
Eye Diseases
Adrenal Cortex Hormones
Intermediate Uveitis
Panuveitis
Posterior Uveitis
Scleritis
Anterior Uveitis
Bullous Pemphigoid
Immunosuppressive Agents
Survival Analysis
Prednisone
Mucous Membrane
Cohort Studies
Therapeutics
Retrospective Studies
Incidence

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Daniel, E., Thorne, J. E., Newcomb, C. W., Pujari, S. S., Kaçmaz, R. O., Levy-Clarke, G. A., ... Kempen, J. H. (2010). Mycophenolate Mofetil for Ocular Inflammation. American Journal of Ophthalmology, 149(3). https://doi.org/10.1016/j.ajo.2009.09.026

Mycophenolate Mofetil for Ocular Inflammation. / Daniel, Ebenezer; Thorne, Jennifer E.; Newcomb, Craig W.; Pujari, Siddharth S.; Kaçmaz, R. Oktay; Levy-Clarke, Grace A.; Nussenblatt, Robert B.; Rosenbaum, James (Jim); Suhler, Eric; Foster, C. Stephen; Jabs, Douglas A.; Kempen, John H.

In: American Journal of Ophthalmology, Vol. 149, No. 3, 03.2010.

Research output: Contribution to journalArticle

Daniel, E, Thorne, JE, Newcomb, CW, Pujari, SS, Kaçmaz, RO, Levy-Clarke, GA, Nussenblatt, RB, Rosenbaum, JJ, Suhler, E, Foster, CS, Jabs, DA & Kempen, JH 2010, 'Mycophenolate Mofetil for Ocular Inflammation', American Journal of Ophthalmology, vol. 149, no. 3. https://doi.org/10.1016/j.ajo.2009.09.026
Daniel E, Thorne JE, Newcomb CW, Pujari SS, Kaçmaz RO, Levy-Clarke GA et al. Mycophenolate Mofetil for Ocular Inflammation. American Journal of Ophthalmology. 2010 Mar;149(3). https://doi.org/10.1016/j.ajo.2009.09.026
Daniel, Ebenezer ; Thorne, Jennifer E. ; Newcomb, Craig W. ; Pujari, Siddharth S. ; Kaçmaz, R. Oktay ; Levy-Clarke, Grace A. ; Nussenblatt, Robert B. ; Rosenbaum, James (Jim) ; Suhler, Eric ; Foster, C. Stephen ; Jabs, Douglas A. ; Kempen, John H. / Mycophenolate Mofetil for Ocular Inflammation. In: American Journal of Ophthalmology. 2010 ; Vol. 149, No. 3.
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AU - Newcomb, Craig W.

AU - Pujari, Siddharth S.

AU - Kaçmaz, R. Oktay

AU - Levy-Clarke, Grace A.

AU - Nussenblatt, Robert B.

AU - Rosenbaum, James (Jim)

AU - Suhler, Eric

AU - Foster, C. Stephen

AU - Jabs, Douglas A.

AU - Kempen, John H.

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N2 - Purpose: To evaluate mycophenolate mofetil as a single noncorticosteroid immunosuppressive treatment for noninfectious ocular inflammatory diseases. Design: Retrospective cohort study. Methods: Characteristics of patients with noninfectious ocular inflammation treated with mycophenolate mofetil at 4 subspecialty clinics from 1995 to 2007 were abstracted by expert reviewers in a standardized chart review of every eye at every visit. Main outcomes measured were control of inflammation, corticosteroid-sparing effects, and discontinuation of mycophenolate mofetil (including the reasons for discontinuation). Survival analysis was used to estimate the incidence of outcomes, and to identify risk factors for each. Results: Among 236 patients (397 eyes) treated with mycophenolate mofetil monotherapy, 20.3%, 11.9%, and 39.8% had anterior uveitis, intermediate uveitis, and posterior uveitis or panuveitis respectively; 14% had scleritis; 7.6% had mucous membrane pemphigoid; and 6.4% had other ocular inflammatory diseases. By Kaplan-Meier estimation, complete control of inflammation-sustained over consecutive visits spanning at least 28 days-was achieved in 53% and 73% of patients within 6 months and 1 year respectively. Systemic corticosteroid dosage was reduced to 10 mg of prednisone or less, while maintaining sustained control of inflammation, in 41% and 55% of patients in 6 months and 1 year respectively. Twelve percent of patients discontinued mycophenolate mofetil within the first year because of side effects of therapy. Conclusions: Given sufficient time, mycophenolate mofetil was effective in managing ocular inflammation in approximately half of the treated patients. Treatment-limiting side effects were observed in 12% of patients and typically were reversible.

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