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Treatment of chronic plaque-stage psoriasis and psoriatic arthritis with mycophenolate mofetil
M Grundmann-Kollmann1, G Mooser, P Schraeder
1Department of Dermatology, Johann Wolfgang Goethe University, Frankfurt/Main, Germany.
Abstract:
Mycophenolate mofetil (MMF), a widely used immunosuppressant in organ transplantation, is a recent addition to the therapeutic armamentarium of autoimmune and inflammatory skin disorders in dermatology. We describe 5 patients with moderate to severe chronic plaque psoriasis and 6 patients with psoriatic arthritis that was refractory to conventional systemic and/or topical antipsoriatic treatment who were treated with MMF monotherapy (2 g/d) in a 10-week study. Although MMF was tolerated well in all patients, only patients with moderate psoriasis and psoriatic arthritis improved with therapy, whereas patients with severe psoriasis did not respond to MMF. Although MMF seems to be effective and safe for blistering autoimmune diseases and pyoderma gangrenosum, our data do not allow optimistic statements on the use of MMF in severe plaque-stage psoriasis. However, MMF may develop into an interesting therapeutic alternative for patients with psoriatic arthritis.
Insights
Mycophenolate mofetil (MMF) showed effectiveness in treating psoriatic arthritis but not severe chronic plaque psoriasis. This immunosuppressant was well-tolerated, suggesting potential for psoriatic arthritis patients refractory to other treatments.
Area of Science:
- Dermatology
- Immunology
- Rheumatology
Background:
- Mycophenolate mofetil (MMF) is an immunosuppressant used in organ transplantation.
- MMF is increasingly utilized for autoimmune and inflammatory skin conditions.
Purpose of the Study:
- To evaluate the efficacy and safety of MMF monotherapy in patients with chronic plaque psoriasis and psoriatic arthritis.
- To assess MMF's response in moderate to severe psoriasis and refractory psoriatic arthritis.
Main Methods:
- A 10-week study involving 5 patients with chronic plaque psoriasis and 6 with psoriatic arthritis.
- All patients received MMF monotherapy at a dosage of 2 g/day.
- Patients had previously shown refractoriness to conventional treatments.
Main Results:
- MMF was well-tolerated by all participants.
- Patients with moderate psoriasis and psoriatic arthritis demonstrated improvement.
- Patients with severe psoriasis did not exhibit a positive response to MMF therapy.
Conclusions:
- MMF shows promise as a therapeutic option for psoriatic arthritis, particularly in cases resistant to other treatments.
- MMF's efficacy in severe plaque psoriasis is not supported by this study.
- MMF is generally safe and effective for blistering autoimmune diseases and pyoderma gangrenosum.