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Mycophenolate mofetil in refractory inflammatory bowel disease.
A C Ford1, R J Towler, P Moayyedi
1Centre for Digestive Diseases, Leeds General Infirmary, Leeds, UK; City Hospital NHS Trust, Birmingham, UK.
Alimentary Pharmacology & Therapeutics
|June 6, 2003
Summary
Mycophenolate mofetil offers a potential treatment for severe inflammatory bowel disease refractory to other therapies, with approximately 40% achieving remission and steroid withdrawal. However, about 60% either did not tolerate the drug or did not respond.
Area of Science:
- Gastroenterology
- Immunosuppressive Therapy
- Inflammatory Bowel Disease Research
Background:
- Limited clinical data exists on mycophenolate mofetil for refractory inflammatory bowel disease (IBD).
- Previous claims suggest efficacy and good tolerability in IBD management.
Purpose of the Study:
- To evaluate the clinical experience with mycophenolate mofetil in refractory IBD.
- To assess remission rates, tolerability, toxicity, and efficacy in a real-world setting.
Main Methods:
- Retrospective audit of 39 IBD patients treated with mycophenolate mofetil (1-2 g/day) over three years.
- Analysis included patient history of azathioprine intolerance/non-response and steroid dependency.
Main Results:
- 22 patients discontinued mycophenolate mofetil (11 intolerance, 10 lack of efficacy).
- Of 17 patients remaining on therapy, 16 achieved remission and steroid withdrawal.
- No major toxicity or sepsis was observed.
Conclusions:
- Mycophenolate mofetil achieved remission and steroid withdrawal in ~40% of severe, refractory IBD patients.
- ~30% experienced intolerance, and ~30% showed no response.
- The drug may benefit steroid-dependent, azathioprine-refractory IBD patients.
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