TY - JOUR
T1 - Mycophenolate mofetil in the treatment of neuromyelitis optica spectrum disorder
AU - Huh, So Young
AU - Kim, Su Hyun
AU - Hyun, Jae Won
AU - Joung, Ae Ran
AU - Park, Min Su
AU - Kim, Byung Jo
AU - Kim, Ho Jin
N1 - Publisher Copyright:
Copyright 2014 American Medical Association. All rights reserved.
PY - 2014/11/1
Y1 - 2014/11/1
N2 - IMPORTANCE: Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune inflammatory disorder of the central nervous system. Recently, various immunosuppressant medications were introduced as therapeutic options for preventing relapse of NMOSD. However, our understanding of the effectiveness ofmycophenolate mofetil (MMF) in treating patients with NMOSD is based on only a small number of studies. OBJECTIVE: To evaluate the efficacy and safety of MMF treatment in patients with NMOSD. DESIGN, SETTING, AND PARTICIPANTS: A 3-center retrospective review of our experiences, examining results from 59 patients with NMOSD (24 with neuromyelitis optica and 35 with a limited form of the disease) who were treated with MMF (1000-2000mg/d). MAIN OUTCOMES AND MEASURES: Patients' annualized relapse rate, disability as measured by the Expanded Disability Status Scale, and experience of adverse effects due to MMF were assessed. RESULTS: Of the 59 patients, 1 with NMOSD who had to discontinue MMF use in the first month due to a rash was excluded. The remaining 58 patients were included in the drug-efficacy analysis. The median post-MMF annualized relapse rate was significantly lower than the pre-MMF annualized relapse rate (0.0 vs 1.5; P < .001). The Expanded Disability Status Scale scores also significantly decreased after MMF treatment (3.0 vs 2.5; P = .005). Thirty-five patients (60%) were relapse free, and Expanded Disability Status Scale scores were stabilized or improved in 53 patients (91%). Fourteen patients discontinued MMF treatment owing to ongoing relapse (10 patients), rash (1 patient), pregnancy (1 patient), and financial problems (2 patients), but MMF was generally well tolerated. CONCLUSIONS AND RELEVANCE: In this observational study, MMF treatment induced reduction of relapse frequency, stabilized or improved disability, and was well tolerated in patients with NMOSD.
AB - IMPORTANCE: Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune inflammatory disorder of the central nervous system. Recently, various immunosuppressant medications were introduced as therapeutic options for preventing relapse of NMOSD. However, our understanding of the effectiveness ofmycophenolate mofetil (MMF) in treating patients with NMOSD is based on only a small number of studies. OBJECTIVE: To evaluate the efficacy and safety of MMF treatment in patients with NMOSD. DESIGN, SETTING, AND PARTICIPANTS: A 3-center retrospective review of our experiences, examining results from 59 patients with NMOSD (24 with neuromyelitis optica and 35 with a limited form of the disease) who were treated with MMF (1000-2000mg/d). MAIN OUTCOMES AND MEASURES: Patients' annualized relapse rate, disability as measured by the Expanded Disability Status Scale, and experience of adverse effects due to MMF were assessed. RESULTS: Of the 59 patients, 1 with NMOSD who had to discontinue MMF use in the first month due to a rash was excluded. The remaining 58 patients were included in the drug-efficacy analysis. The median post-MMF annualized relapse rate was significantly lower than the pre-MMF annualized relapse rate (0.0 vs 1.5; P < .001). The Expanded Disability Status Scale scores also significantly decreased after MMF treatment (3.0 vs 2.5; P = .005). Thirty-five patients (60%) were relapse free, and Expanded Disability Status Scale scores were stabilized or improved in 53 patients (91%). Fourteen patients discontinued MMF treatment owing to ongoing relapse (10 patients), rash (1 patient), pregnancy (1 patient), and financial problems (2 patients), but MMF was generally well tolerated. CONCLUSIONS AND RELEVANCE: In this observational study, MMF treatment induced reduction of relapse frequency, stabilized or improved disability, and was well tolerated in patients with NMOSD.
UR - http://www.scopus.com/inward/record.url?scp=84919343736&partnerID=8YFLogxK
U2 - 10.1001/jamaneurol.2014.2057
DO - 10.1001/jamaneurol.2014.2057
M3 - Article
C2 - 25199960
AN - SCOPUS:84919343736
VL - 71
SP - 1372
EP - 1378
JO - JAMA Neurology
JF - JAMA Neurology
SN - 2168-6149
IS - 11
ER -