Mycophenolate Mofetil in the Treatment of Neuromyelitis Optica Spectrum Disorder

Title
Mycophenolate Mofetil in the Treatment of Neuromyelitis Optica Spectrum Disorder
Author(s)
박민수허소영[허소영]김수현[김수현]현재원[현재원]정애란[정애란]김병조[김병조]김호진[김호진]
Keywords
PROLIFERATIVE LUPUS NEPHRITIS; LONG-TERM; MULTIPLE-SCLEROSIS; CHINESE PATIENTS; RITUXIMAB; MITOXANTRONE; EFFICACY; AZATHIOPRINE; THERAPY; SAFETY
Issue Date
201411
Publisher
AMER MEDICAL ASSOC
Citation
JAMA NEUROLOGY, v.71, no.11, pp.1372 - 1378
Abstract
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 (1000-2000 mg/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.
URI
http://hdl.handle.net/YU.REPOSITORY/30517http://dx.doi.org/10.1001/jamaneurol.2014.2057
ISSN
2168-6149
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의과대학 > 신경과학교실 > Articles
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