Mycophenolate mofetil in multiple sclerosis: a multicentre retrospective study on 344 patients

Mycophenolate mofetil (MMF) is an immunosuppressive agent and inhibits purine synthesis in lymphocytes. It exerts broad effects on T cells, B cells and macrophages. MMF has been used in several case studies and in small short term clinical trials. MMF is commonly used for preventing graft rejection.

This retrospective study from France assessed the safety and efficacy of MMF in people with MS. The main outcome criterion was annualised relapse rate (ARR) in the 1 year period after onset of MMF compared with the 1 year control period. A subgroup analysis was included on other treatments, like mitoxantrone or cyclophosphamide, in the 2 years preceding initiation of MMF. The cohort included 344 people from three French MS centres; with 149 patients previously treated with another immunosuppressant (IS group). Mean treatment duration was 25.3 months.

They observed a significant reduction of 68.1% in ARR after 1 year of treatment in the whole group compared with the control period. Adverse events occurred in 11% of patients and consisted mainly of digestive disorders, benign infections, asthenia and transitory lymphopenia. In relation to disability, in a subgroup of patients without previous immunosuppressant treatment, EDSS remained stable between initiation and 1 year after the beginning of MMF. This study suggests that MMF can improve or stabilise MS patients.

Authors: Michel L, Vukusic S

Source: J Neurol Neurosurg Psychiatry. 2013 May 23. [Epub ahead of print]

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