Mycophenolate mofetil therapy for inflammatory eye disease

Purpose: To evaluate treatment outcomes with mycophenolate mofetil in patients with inflammatory eye disease. Design: Retrospective case series. Participants: Eighty-four consecutive patients with inflammatory eye disease treated with mycophenolate mofetil at an academic referral center. Methods: Medical records were reviewed for treatment with mycophenolate mofetil. Dose of mycophenolate mofetil, response to therapy, dose of prednisone, use of other immunosuppressive drugs, and side effects associated with the use of mycophenolate mofetil were recorded. Main Outcome Measures: Ability to control ocular inflammation with mycophenolate mofetil and to taper prednisone to ≤10 mg daily, and incidence of treatment-related side effects. Results: Of the 84 patients treated with mycophenolate mofetil, 61% had uveitis, 17% had scleritis, 11% had mucous membrane pemphigoid, and 11% had orbital or other inflammatory disease. Forty-three percent of patients treated with mycophenolate mofetil had been treated with at least one other immunosuppressive drug previously. The median dose of prednisone at the start of mycophenolate mofetil therapy was 40 mg, and 82% of the patients were considered a treatment success, as judged by the ability to control the inflammation and taper prednisone to ≤10 mg daily. Median time to treatment success was 3.5 months. Mycophenolate mofetil therapy was discontinued due to insufficient efficacy at a rate of 0.10 per person-year (PY) and due to side effects at a rate of 0.08/PY. The most frequent side effect was gastrointestinal upset, with a rate of 0.19/PY. Conclusions: These data suggest that mycophenolate mofetil may be an effective corticosteroid-sparing agent in the treatment of inflammatory eye disease with a manageable side effect profile.