American Journal of Ophthalmology
Volume 149, Issue 3 , Pages 423-432.e2 , March 2010

Mycophenolate Mofetil for Ocular Inflammation

  • Ebenezer Daniel

      Affiliations

    • The Fundus Photograph Reading Center, The University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    • Department of Ophthalmology, The University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    • ,
  • Jennifer E. Thorne

      Affiliations

    • Department of Ophthalmology, The Johns Hopkins University, Baltimore, Maryland
    • Department of Epidemiology, The Johns Hopkins University, Baltimore, Maryland
    • ,
  • Craig W. Newcomb

      Affiliations

    • Center for Clinical Epidemiology and Biostatistics, The University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    • Department of Biostatistics and Epidemiology, The University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    • ,
  • Siddharth S. Pujari

      Affiliations

    • Massachusetts Eye Research and Surgery Institute, Cambridge, Massachusetts
    • ,
  • R. Oktay Kaçmaz

      Affiliations

    • Massachusetts Eye Research and Surgery Institute, Cambridge, Massachusetts
    • Department of Ophthalmology, Mount Sinai School of Medicine, New York, New York
    • ,
  • Grace A. Levy-Clarke

      Affiliations

    • Department of Ophthalmology, St. Luke's Cataract and Laser Institute, Tarpon Springs, Florida
    • Laboratory of Immunology, National Eye Institute, Bethesda, Maryland
    • ,
  • Robert B. Nussenblatt

      Affiliations

    • Laboratory of Immunology, National Eye Institute, Bethesda, Maryland
    • ,
  • James T. Rosenbaum

      Affiliations

    • Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon
    • Department of Medicine, Oregon Health & Science University, Portland, Oregon
    • ,
  • Eric B. Suhler

      Affiliations

    • Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon
    • Portland Veterans' Affairs Medical Center, Portland, Oregon
    • ,
  • C. Stephen Foster

      Affiliations

    • Massachusetts Eye Research and Surgery Institute, Cambridge, Massachusetts
    • Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
    • ,
  • Douglas A. Jabs

      Affiliations

    • Department of Ophthalmology, The University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    • Center for Clinical Epidemiology and Biostatistics, The University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    • Department of Ophthalmology, Mount Sinai School of Medicine, New York, New York
    • Department of Medicine, Mount Sinai School of Medicine, New York, New York
    • ,
  • John H. Kempen

      Affiliations

    • Department of Ophthalmology, The University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    • Center for Clinical Epidemiology and Biostatistics, The University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    • Department of Biostatistics and Epidemiology, The University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    • Corresponding Author InformationInquiries to John H. Kempen, MD, PhD, Center for Preventive Ophthalmology and Biostatistics, Department of Ophthalmology, University of Pennsylvania, 3535 Market St, Suite 700, Philadelphia, PA 19104

,Accepted 26 September 2009.

References 

  1. Nussenblatt RB. The natural history of uveitis. Int Ophthalmol. 1990;14:303–308
  2. Jabs DA, Rosenbaum JT, Foster CS, et al. Guidelines for the use of immunosuppressive drugs in patients with ocular inflammatory disorders: recommendations of an expert panel. Am J Ophthalmol. 2000;130:492–513
  3. Lau CH, Comer M, Lightman S. Long-term efficacy of mycophenolate mofetil in the control of severe intraocular inflammation. Clin Experiment Ophthalmol. 2005;31:487–491
  4. Doycheva D, Deuter C, Stuebiger N, Biester S, Zierhut M. Mycophenolate mofetil in the treatment of uveitis in children. Br J Ophthalmol. 2007;91:180–184
  5. Siepmann K, Huber M, Stubiger N, et al. Mycophenolate mofetil is a highly effective and safe immunosuppressive agent for the treatment of uveitis (A retrospective analysis of 106 patients). Graefes Arch Clin Exp Ophthalmol. 2006;244:788–794
  6. Zierhut M, Stübiger N, Siepmann K, et al. MMF and eye disease. Lupus. 2005;14(Suppl 1):S50–S54
  7. Allison AC. Mechanisms of action of mycophenolate mofetil. Lupus. 2005;14:S2–S8
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  9. Iaccarino L, Arienti S, Rampudda M, et al. Mycophenolate mofetil in lupus glomerulonephritis: effectiveness and tolerability. Ann N Y Acad Sci. 2007;1110:516–524
  10. Appel GB, Radhakrishnan J, Ginzler EM. Use of mycophenolate mofetil in autoimmune and renal diseases. Transplantation. 2005;80:S265–S271
  11. Galor A, Jabs DA, Leder HA, et al. Comparison of antimetabolite drugs as corticosteroid-sparing therapy for noninfectious ocular inflammation. Ophthalmology. 2008;115:1826–1832
  12. Thorne JE, Jabs DA, Qazi FA, et al. Mycophenolate mofetil therapy for inflammatory eye disease. Ophthalmology. 2005;112:1472–1477
  13. Choudhary A, Harding SP, Bucknall RC, Pearce IA. Mycophenolate mofetil as an immunosuppressive agent in refractory inflammatory eye disease. J Ocul Pharmacol Ther. 2006;22:168–175
  14. Teoh SC, Hogan AC, Dick AD, Lee RW. Mycophenolate mofetil for the treatment of uveitis. Am J Ophthalmol. 2008;146:752–760
  15. Saw VP, Dart JK, Rauz S, et al. Immunosuppressive therapy for ocular mucous membrane pemphigoid strategies and outcomes. Ophthalmology. 2008;115:253–261
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  17. Kempen JH, Daniel E, Gangaputra S, et al. Methods for identifying long-term adverse effects of treatment in patients with eye diseases: the Systemic Immunosuppressive Therapy for Eye Diseases (SITE) Cohort Study. Ophthalmic Epidemiol. 2008;15:47–55
  18. Gangaputra S, Newcomb CW, Liesegang TL, et al. Systemic Immunosuppressive Therapy for Eye Diseases Cohort Study Methotrexate for ocular inflammatory diseases. Ophthalmology. 2009;116:2188–2198
  19. Pasadhika S, Kempen JH, Newcomb C, et al. Azathioprine for ocular inflammatory diseases. Am J Ophthalmol. 2009;148:500–509
  20. Schimmer BP, Parker KL. Adrenocorticotropic hormone; Adrenocortical steroids and their synthetic analogs; inhibitors of the synthesis and actions of adrenocortical hormones. In:  Brunton LL,  Parker KL editor. Goodman and Gilman's The Pharmacological Basis of Therapeutics. New York: The McGraw-Hill Companies; 2006;p. 1587–1613
  21. Thorne JE, Woreta FA, Jabs DA, Anhalt GJ. Treatment of ocular mucous membrane pemphigoid with immunosuppressive drug therapy. Ophthalmology. 2008;115:2146–2152
  22. Kempen JH, Gangaputra S, Daniel E, et al. Long-term risk of malignancy among patients treated with immunosuppressive agents for ocular inflammation: a critical assessment of the evidence. Am J Ophthalmol. 2008;146:802–812
  23. Kempen JH, Daniel E, Dunn JP, et al. Risk of overall and cancer mortality among patients with ocular inflammation treated with immunosuppressive therapy: retrospective cohort study. BMJ. 2009;339:b2480
  24. Sobrin L, Christen W, Foster CS. Mycophenolate mofetil after methotrexate failure or intolerance in the treatment of scleritis and uveitis. Ophthalmology. 2008;115:1416–1421
  25. Ostensen M, Lockshin M, Doria A, et al. Update on safety during pregnancy of biological agents and some immunosuppressive anti-rheumatic drugs. Rheumatology. 2000;47:28–31
  26. Huang SY, Chueh HY, Shaw SW, et al. Sonographic diagnosis of fetal malformations associated with mycophenolate mofetil exposure in utero. Am J Obstet Gynecol. 2008;199:6–8
  27. Jabs DA, Nussenblatt RB, Rosenbaum JT. Standardization of uveitis nomenclature for reporting clinical data (Results of the First International Workshop). Am J Ophthalmol. 2005;140:509–516

 Supplemental Material available at AJO.com.

PII: S0002-9394(09)00739-9

doi: 10.1016/j.ajo.2009.09.026

American Journal of Ophthalmology
Volume 149, Issue 3 , Pages 423-432.e2 , March 2010

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