Mycophenolate mofetil therapy for refractory inflammatory bowel disease.

Journal Article (Journal Article)

BACKGROUND: Mycophenolate mofetil (MMF) is an immunomodulatory drug, and its use in inflammatory bowel disease has previously been reported. The aim of this study was to review the Leeds Colitis Clinic experience of the safety and efficacy of MMF in treating patients with refractory Crohn's disease (CD) and ulcerative colitis (UC). This is an extension of a previously published study from our center with a longer follow-up period and approximately twice the number of patients. METHODS: A retrospective analysis was performed of the records of all patients treated with MMF for inflammatory bowel disease over a 5-year period. RESULTS: Of 70 patients identified, 67 had previously been treated with azathioprine unsuccessfully. Seventeen of the 70 patients had been successfully maintained in remission with MMF for an average duration of 33 months. Treatment with MMF was discontinued for 53 patients, 17 because of side effects and 36 because they had not responded to the treatment. CONCLUSIONS: In our series, 17 patients (24.3%) had a sustained steroid-free remission with MMF therapy. Nineteen patients (27%) experienced side effects, of which 17 (24.3% of the total group) had to discontinue therapy. An additional 36 (51.4%) required an escalation in medical therapy or surgery because of failure of the MMF therapy. MMF may have a role in the treatment of refractory inflammatory bowel disease, especially in patients who have previously failed standard therapies such as azathioprine.

Full Text

Duke Authors

Cited Authors

  • Palaniappan, S; Ford, AC; Greer, D; Everett, SM; Chalmers, DM; Axon, ATR; Hamlin, PJ

Published Date

  • December 2007

Published In

Volume / Issue

  • 13 / 12

Start / End Page

  • 1488 - 1492

PubMed ID

  • 17924566

International Standard Serial Number (ISSN)

  • 1078-0998

Digital Object Identifier (DOI)

  • 10.1002/ibd.20258

Language

  • eng

Conference Location

  • England