Uso de micofenolato mofetilo fuera de registro en enfermedades inmunomediadas

Off-label use of mycophenolate mofetil in immune-mediated diseases

Danza, Álvaro - Graña, Diego - Casas, Cecilia - Domínguez, Viviana - Rebella, Martín

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.

Detalles Bibliográficos
2022
Glucocorticoids
Immune system diseases
Lupus erythematosus
Systemic
Mycophenolic acid
EFECTOS COLATERALES Y REACCIONES ADVERSAS RELACIONADOS CON MEDICAMENTOS
ENFERMEDADES DEL SISTEMA INMUNE
ÁCIDO MICOFENÓLICO
LUPUS ERITEMATOSO SISTÉMICO
NEFRITIS LÚPICA
GLUCOCORTICOIDES
USOS TERAPÉUTICOS
HUMANOS
INMUNOSUPRESORES
USO FUERA DE LO INDICADO
ESTUDIOS RETROSPECTIVOS
RESULTADO DEL TRATAMIENTO
Español
Universidad de la República
COLIBRI
https://hdl.handle.net/20.500.12008/54613
Acceso abierto
Licencia Creative Commons Atribución (CC - By 4.0)