Uso de micofenolato mofetilo fuera de registro en enfermedades inmunomediadas

• Autores: Álvaro Danza, Diego Carlos Graña Cruz, Cecilia Casas, Viviana Domínguez, Martín Rebella
• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 150, Nº. 10, 2022, págs. 1317-1324
• Idioma: español
• Títulos paralelos:
  • Off-label use of mycophenolate mofetil in immune-mediated diseases
• Enlaces
  • Texto completo
• Resumen

  • Background: Mycophenolate mofetil (MMF) is a largely used immunosuppressive agent in the prevention of transplant rejection and lupus nephritis. Its use has been extended to other immune-mediated diseases (ID). Aim: To assess the off-label use of MMF, its performance as a glucocorticoid sparing agent, the therapeutic response, and its adverse effects. Material and Methods: A retrospective study was performed. One hundred-seven patients aged 58 ± 16 years (83% females) who received MMF for ID in off label uses between 2016 and 2018 were included. The study variables were cause of MMF indication, sex, age, use as a first- or second-line treatment and maintenance dosing. The cumulative doses of glucocorticoids six months before and after MMF indication were compared. Results: MMF was used as a second-line therapy in 66 patients (62%). The mean maintenance dose of MMF was 1,500 ± 540 mg/day. Prednisone cumulative doses were 3,908 ± 2,173 and 1,672 ± 1,083 milligrams six months before and six months after starting MMF, respectively (p < 0.01). Adverse effects were identified in 21 (20%) cases, none of them serious. Conclusions: Mycophenolate has a favorable response profile as a second line immunosuppressive agent. It is effective as a glucocorticoid sparing drug. The safety profile is also favorable as adverse effects were scanty and mild.