Efficacy of mycophenolate mofetil in antimalarial-resistant cutaneous lupus erythematosus

Monoclonal antibody against macrophage colony-stimulating factor suppresses circulating monocytes and tissue macrophage function but does not alter cell infiltration/activation in cutaneous lesions or clinical outcomes in patients with cutaneous lupus erythematosus

“…Standard pharmacological treatment of CLE includes topical or systemic corticosteroids and anti-malarial agents, but these options may be of limited effectiveness and may result in burdensome local and systemic side effects [7]. Some patients with CLE or DLE resistant to standard therapies may respond to immunomodulators such as azathioprine [8], methotrexate [9] and mycophenolate mofetil [10], although the benefits of the latter agents must also be weighed against the potential for toxicity.…”

Mepacrine in Recalcitrant Cutaneous Lupus Erythematosus: Old-fashioned or Still Useful?

“…While unresponsiveness to HCQ may be due to low blood concentrations because of poor adherence to treatment (7), there obviously remains a subset of CLE patients experiencing no or only limited amelioration with HCQ. In these patients, numerous systemic treatments have been proposed including myco phenolate mofetil, methotrexate, dapsone, thalidomide, retinoids, intravenous immunoglobulin and biologicals as well as MPC either as monotherapy or in combination (8)(9)(10). These recommendations are mostly based upon expert opinions, case reports and uncontrolled trials.…”

Current and future treatment options for cutaneous lupus erythematosus

“…In CLE, a retrospective review of 24 patients with antimalarial recalcitrant disease was performed. The majority of patients treated with doses up to 3 g a day showed improvement [47]. The most common side effect is gastrointestinal symptoms.…”

“…The mechanism of action in CLE remains elusive but antimalarials are known to have photoprotective and immunomodulating effects on the skin [27,28]. [84] Systemic treatments Antimalarials A Monitor for retinopathy with hydroxychloroquine and chloroquine [29] Retinoids A Most practical for hypertrophic discoid lesions [35] Dapsone C Most practical for bullous lupus [38] IVIG C [57] Clofazimine A [85] Methotrexate C [33] Azathioprine C [42] Mycophenolate mofetil C [47] Thalidomide B Monitor for potential irreversible peripheral neuropathy [86] Leflunomide D Reports of this drug causing lupus-like reactions [87] Other Extracorporeal photopheresis D [88] Prevention Sunscreen A [16] Vitamin D B…”