Mycophenolate mofetil is a valid option in patients with inflammatory bowel disease resistant to TNF-α inhibitors and conventional immunosuppressants

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• 作者：Fabio Salvatore Macaluso^a ; ^{fsmacaluso@gmail.com} ; Marcello Maida^b ; Sara Renna^a ; Emanuele Orlando^a ; Marco Affronti^a ; Chiara Sapienza^a ; Mariangela Dimarco^a ; Rosalba Orlando^a ; Giulia Rizzuto^a ; Mario Cottone^a ; Ambrogio Orlando^a
• 关键词：Biologics ; Crohn&rsquo ; s disease ; Immunosuppressants ; Ulcerative colitis
• 刊名：Digestive and Liver Disease
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：49
• 期：2
• 页码：157-162
• 全文大小：633 K
• 卷排序：49

文摘

Few studies investigated the role of mycophenolate mofetil in inflammatory bowel disease, and none of them had specifically focused on patients with previous multiple intolerances and/or nonresponses to conventional immunosuppressants and biologics.AimsTo evaluate clinical benefit and tolerability profile of mycophenolate mofetil in patients with inflammatory bowel disease and limited treatment options.MethodsAll consecutive patients with previous multiple intolerances and/or nonresponses to immunosuppressants and biologics who started an off-label treatment with mycophenolate mofetil from January 2014 to February 2016 were entered in a prospectively maintained database.ResultsTwenty-four patients were included. Four weeks after initiation of mycophenolate mofetil therapy, a steroid-free remission was achieved in 4 patients (16.7%), while a clinical response in 13 (54.1%). At the end of follow-up, 12 patients (50.0%) remained on mycophenolate mofetil. Six achieved and maintained steroid-free remission throughout the study period (25.0%), and a further 6 patients (25.0%) achieved a clinical response with complete discontinuation of steroids. Twelve patients (50.0%) were considered as treatment failure, and five of them underwent surgery.ConclusionsThis is the first experience reporting a clinical benefit and tolerability of mycophenolate mofetil in patients with inflammatory bowel disease and multiple previous failures to other immunosuppressants and/or biologics.