Monitoring trough plasma concentrations of mycophenolate mofetil in patients with uveitis

Abstract

MMF was effective in the majority of patients with uveitis with an acceptable profile of side-effects. TDM of MMF in patients with uveitis is clinically practicable and may help to optimize individual immunosuppressive therapy. We estimated that MMF dosages in the range of 0.5-1.5 g/day might be sufficient for treating uveitis and we recommend an initial target range of 2-4 microg/mL, which included 50% of our results. Randomized controlled trials are essential to confirm the efficacy of MMF in uveitis.

Clinical Immunology Review Series: An approach to the patient with recurrent orogenital ulceration, including Behçet's syndrome

“…Although used commonly in other systemic vasculitides, there are few data concerning the use of mycophenylate in BD. A single open study found no benefit in mucocutaneous disease [64]; however, beneficial effects have been reported in case reports [65] and in patients with BD included in larger studies of uveitis [66]. Given its similar mode of action to azathioprine, and its enhanced safety profile, mycophenylate merits further evaluation in BD.…”

Mycophenolate mofetil as an immunomodulator in refractory noninfectious uveitis

“…Visual acuity measured with a Snellen chart was converted to logMar (16,17) . Events are presented as the incidence rate (person-time rate) during the 24 months of observation.…”

“…Doses ≥3 g/day may increase the risk of toxicity (4)(5)(6) . The appropriate dose may lie between 2 and 3 g/day and may require individualization depending on the clinical course or other factors, e.g., monitoring of MMF plasma concentrations (17) . MMF was moderately well tolerated, with four patients (25%) ex periencing side effects.…”

“…In uveitis, the dose is usually up to 2 g per day, and side effects are mild and transient. Plasma concentration monitoring of MPA may optimize the use of MMF and minimize its side effects (17) . The present study aimed to further characterize the efficacy of MMF to control refractory noninfectious uveitis in a tertiary Uveitis Service in São Paulo, Brazil.…”

In Vitro Evidence for Mycophenolic Acid Dose-Related Cytotoxicity in Human Retinal Cells

“…It is known that systemic MPA concentration of 2.9 ± 1.9 mg/mL is effective in controlling intraocular inflammation in more than 80% of uveitis patients treated with systemic MMF. 20 There are no data on intraocular concentration of MPA after systemic administration of MMF, but it probably is several times lower than systemic concentration, even considering the hematoretinal barrier breakdown in cases of uveitis.…”