Mycophenolate mofetil therapy in adult patients with recalcitrant atopic dermatitis

Dias‐Polak, David; Bergman, Reuven; Avitan‐Hersh, Emily

doi:10.1080/09546634.2018.1468068

Cited by 14 publications

(14 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Some case reports or uncontrolled clinical trial data from adults indicate that MMF could be effective in dermatitis. 127,128,129,130,131 In an observer-blinded randomized controlled trial in 55 patients, a lower dose CSA (3 mg/kg/d) was found to be equally effective to oral MMF (EC-MPS, 1440 mg/d) as a maintenance therapy for severe dermatitis during a maintenance phase of 30 weeks and a 12-week follow-up period. 112 The MMF group had a slower onset of action with 29% of the MMF patients requiring short courses of systemic glucocorticoids compared to none in the CSA group.…”

Section: • Methotrexate (Mtx) Patients Receiving Mtxmentioning

confidence: 99%

Systematic review about 10 interventions in dermatitis. A document from the Latin American Society of Allergy, Asthma, and Immunology

Sánchez

Sánchez²,

Macías-Weinmann

et al. 2019

RAM

View full text Add to dashboard Cite

The Latin American Society of Allergy, Asthma, and Immunology (SLAAI) conducted a systematic search in the Medline and LILACS' database in order to get articles linked to 10 current questions about dermatitis. The assessment of the quality of the evidence and the strength of the recommendations was made through the GRADE system. The completeness and transparency of the recommendations for this clinical guide were assessed with the AGREE Reports Verification Checklist. The final document was shared with physicians, allergists, dermatologists, and pediatricians, and with patients and academic institutions such as universities and medical scientific societies for external assessment. According to the review, clinical scales should be used to measure the severity of the dermatitis, and some interventions such as the use of probiotics may benefit the patient; nevertheless, more studies are required before this management option can be used in the everyday practice. Other interventions such as dietary restrictions and the use of antihistamines seem to be well-founded only in particular cases and they should not be a general recommendation for all patients. This practical guide presents recommendations for the treatment of atopic dermatitis; these recommendations can be helpful for medical staff, patients, and health systems.

show abstract

Section: • Methotrexate (Mtx) Patients Receiving Mtxmentioning

confidence: 99%

Systematic review about 10 interventions in dermatitis. A document from the Latin American Society of Allergy, Asthma, and Immunology

Sánchez

Sánchez²,

Macías-Weinmann

et al. 2019

RAM

View full text Add to dashboard Cite

show abstract

“…Monitoring of liver function and blood cell counts is necessary during the treatment with MTX and AZA. MMF efficacy is comparable to that of CsA in the treatment of AD [42]. The treatment starts at the dose of 1-2 g/day.…”

Section: Dupilumabmentioning

confidence: 89%

“…W trakcie leczenia MTX oraz AZA konieczne jest monitorowanie czynności wątroby i morfologii krwi. MMF ma udowodnioną skuteczność w leczeniu AZS, porównywalną z CsA [42]. Leczenie rozpoczyna się od dawki 1-2 g/dobę.…”

Section: Leczenie Ogólne Poza Wskazaniami Rejestracyjnymiunclassified

Management of severe atopic dermatitis in adult patients

Kobusiewicz¹,

Zalewska-Janowska²,

Lesiak³

2020

View full text Add to dashboard Cite

Atopic dermatitis is a chronic recurrent inflammatory condition of the skin. It can coexist with other atopy-related disorders, e.g. bronchial asthma, allergic rhinitis or food allergy. Beacuse of its chronic course and concomitance of pruritus, atopic dermatitis considerably decreases the quality of life of patients and their family members. Management of atopic dermatitis mainly involves appropriate skin care and daily application of emollients, combined with topical anti-inflammatory treatment. It is essential to initiate systemic immunosuppressive therapy in moderate or severe atopic dermatitis. The aim of the study is to present current therapeutic options for atopic dermatitis in adults, with particular consideration given to the approved biological treatment. Dupilumab was included in the management algorithm as the first-line treatment in moderate or severe atopic dermatitis, unresponsive to topical therapy and in cases in which systemic treatment is contraindicated. stresZcZeNie Atopowe zapalenie skóry to przewlekła, nawrotowa choroba zapalna skóry, która może współistnieć z innymi schorzeniami z kręgu atopii, takimi jak astma oskrzelowa, alergiczny nieżyt nosa oraz alergia pokarmowa. Ze względu na przewlekły przebieg choroby oraz współwystępowanie świądu obniżona jest istotnie jakość życia pacjentów i ich rodzin. Podstawą leczenia jest właściwa pielęgnacja skóry polegająca na codziennym stosowaniu emolientów w połączeniu z miejscowym leczeniem przeciwzapalnym. W atopowym zapaleniu skóry o umiarkowanym lub ciężkim przebiegu istotne jest włączenie immunosupresyjnego leczenia ogólnoustrojowego. Celem opracowania jest przedstawienie aktualnych opcji terapeutycznych w atopowym zapaleniu skóry u dorosłych, szczególnie zarejestrowanego leczenia biologicznego. Dupilumab został włączony do algorytmu postępowania jako leczenie pierwszego wyboru w umiarkowanej do ciężkiej postaci atopowego zapalenia skóry u dorosłych, gdy nie uzyskuje się odpowiedzi na leczenie miejscowe i gdy inne leczenie systemowe nie jest wskazane.

show abstract

“…Mycophenolate mofetil (MMF) is an immunosuppressive drug administered in the prophylaxis against acute rejection after solid organ transplantation as well as in autoimmune diseases [ 1 ], nephrotic syndrome [ 2 , 3 ], and atopic dermatitis [ 4 ]. The MMF active moiety, mycophenolic acid (MPA), is characterized by complex and variable pharmacokinetics and high serum albumin binding (97–99%) [ 1 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

The Evaluation of Multiple Linear Regression–Based Limited Sampling Strategies for Mycophenolic Acid in Children with Nephrotic Syndrome

et al. 2021

View full text Add to dashboard Cite

We evaluated mycophenolic acid (MPA) limited sampling strategies (LSSs) established using multiple linear regression (MLR) in children with nephrotic syndrome treated with mycophenolate mofetil (MMF). MLR-LSS is an easy-to-determine approach of therapeutic drug monitoring (TDM). We assessed the practicability of different LSSs for the estimation of MPA exposure as well as the optimal time points for MPA TDM. The literature search returned 29 studies dated 1998–2020. We applied 53 LSSs (n = 48 for MPA, n = 5 for free MPA [fMPA]) to predict the area under the time-concentration curve (AUCpred) in 24 children with nephrotic syndrome, for whom we previously determined MPA and fMPA concentrations, and compare the results with the determined AUC (AUCtotal). Nine equations met the requirements for bias and precision ±15%. The MPA AUC in children with nephrotic syndrome was predicted the best by four time-point LSSs developed for renal transplant recipients. Out of five LSSs evaluated for fMPA, none fulfilled the ±15% criteria for bias and precision probably due to very high percentage of bound MPA (99.64%). MPA LSS for children with nephrotic syndrome should include blood samples collected 1 h, 2 h and near the second MPA maximum concentration. MPA concentrations determined with the high performance liquid chromatography after multiplying by 1.175 may be used in LSSs based on MPA concentrations determined with the immunoassay technique. MPA LSS may facilitate TDM in the case of MMF, however, more studies on fMPA LSS are required for children with nephrotic syndrome.

show abstract

Mycophenolate mofetil therapy in adult patients with recalcitrant atopic dermatitis

Abstract: Oral MMF may be an effective drug in AD. Due to its good safety profile, it may be recommended as a first-line systemic therapy, or successive to CSA in the long term.

Cited by 14 publications

References 10 publications

Systematic review about 10 interventions in dermatitis. A document from the Latin American Society of Allergy, Asthma, and Immunology

Systematic review about 10 interventions in dermatitis. A document from the Latin American Society of Allergy, Asthma, and Immunology

Management of severe atopic dermatitis in adult patients

The Evaluation of Multiple Linear Regression–Based Limited Sampling Strategies for Mycophenolic Acid in Children with Nephrotic Syndrome

Contact Info

Product

Resources

About