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Mycophenolate mofetil for ocular myasthenia.
1Dept. of Neurology, University of Nevada School of Medicine, 1707 W. Charleston Blvd. Suite 220, Las Vegas, NV 89102, USA. worjun@aol.com
Journal of Neurology
|February 27, 2008
Summary
Mycophenolate mofetil (MM) is a safe and tolerable option for managing ocular myasthenia (OMG). Most patients remained at Stage I disease, with minimal side effects, making it a viable long-term steroid-sparing treatment.
Area of Science:
- Ophthalmology
- Neurology
- Immunology
Background:
- Ocular myasthenia (OMG) often requires long-term management.
- Corticosteroids are commonly used but associated with significant side effects.
- Mycophenolate mofetil (MM) is a potential steroid-sparing immunomodulatory agent for OMG.
Purpose of the Study:
- To evaluate the safety and tolerability of mycophenolate mofetil (MM) for long-term management of ocular myasthenia (OMG).
- To assess MM as a steroid-sparing alternative to corticosteroids in OMG patients.
Main Methods:
- A consecutive series of 31 OMG patients initiated on MM between December 2000 and December 2006 were followed.
- Patients were treated with prednisone (40-60 mg/d) and MM (up to 1.0 g/d).
- Prednisone was tapered off over 4 weeks after symptom resolution.
Main Results:
- 87% (27/31) of patients continued MM long-term.
- 13% (4/31) discontinued MM within 4 months.
- Of those continuing MM, 93% remained at Stage I disease; 7% generalized and required additional prednisone.
- MM-related adverse events included nausea (9/31), diarrhea (5/31), and vomiting (1/31).
- No infections, cytopenias, or malignancies were observed.
Conclusions:
- Mycophenolate mofetil (MM) at 1.0 g/d is safe and well-tolerated for long-term immunosuppression in OMG.
- 87% of OMG patients switched to MM remained at Stage I disease for a mean of 4.2 years.
- MM offers a viable steroid-sparing treatment option for ocular myasthenia.
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