Brief Articles
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World J Gastroenterol. Apr 7, 2009; 15(13): 1594-1599
Published online Apr 7, 2009. doi: 10.3748/wjg.15.1594
Use of mycophenolate mofetil in inflammatory bowel disease
Terrence Tan, Ian Craig Lawrance
Terrence Tan, Ian Craig Lawrance, Department of Gastroenterology, Fremantle Hospital, 6059 WA, Australia
Ian Craig Lawrance, Centre for Inflammatory Bowel Diseases, Fremantle Hospital, 6059 WA, Australia; Department of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, 6059 WA, Australia
Author contributions: Tan T and Lawrance IC contributed equally to this work.
Correspondence to: Ian Craig Lawrance, Department of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, 6059 WA, Australia. ian.lawrance@uwa.edu.au
Telephone: +61-8-94316347
Fax: + 61-8-94313160
Received: October 14, 2008
Revised: March 4, 2009
Accepted: March 11, 2009
Published online: April 7, 2009
Abstract

AIM: To assess the efficacy and safety of mycophenolate mofetil (MMF) prospectively in inflammatory bowel disease (IBD) patients intolerant or refractory to conventional medical therapy.

METHODS: Crohn’s disease (CD) or ulcerative colitis/IBD unclassified (UC/IBDU) patients intolerant or refractory to conventional medical therapy received MMF (500-2000 mg bid). Clinical response was assessed by the Harvey Bradshaw index (HBI) or colitis activity index (CAI) after 2, 6 and 12 mo of therapy, as were steroid usage and adverse effects.

RESULTS: Fourteen patients (9 CD/5 UC/IBDU; 8M/6F; mean age 50.4 years, range 28-67 years) were treated and prospectively assessed for their response to oral MMF. Of the 11 patients who were not in remission on commencing MMF, 7/11 (63.6%) achieved remission by 8 wk. All 3 patients in remission on commencing MMF maintained their remission. Ten patients were still on MMF at 6 mo with 9/14 (64.3%) in remission, while of 12 patients followed for 12 mo, 8 were in remission without dose escalation (66.7%). Three patients were withdrawn from the MMF due to drug intolerance. There were no serious adverse events attributed due to the medication.

CONCLUSION: MMF demonstrated efficacy in the management of difficult IBD. MMF appeared safe, well tolerated and efficacious for both short and long-term therapy, without the need for dose escalation. Further evaluation of MMF comparing it to conventional immunosuppressants is required.

Keywords: Inflammatory bowel disease, Mycophenolate mofetil, Therapy, Crohn’s disease, Ulcerative colitis