Mycophenolate sodium for the treatment of chronic non-infectious uveitis of childhood

Br J Ophthalmol. 2016 Aug;100(8):1071-5. doi: 10.1136/bjophthalmol-2015-306701. Epub 2015 Nov 13.

Abstract

Aim: To assess the efficacy and tolerability of mycophenolate sodium (MPS) in the therapy of children with chronic non-infectious uveitis.

Methods: Retrospective analysis of 23 children with chronic uveitis, treated with MPS, with a follow-up of at least 6 months. The main outcome measures were time to uveitis reactivation and corticosteroid-sparing effect under MPS treatment. The secondary outcome measures were best-corrected visual acuity (BCVA) and treatment-related side effects.

Results: From 23 patients included in the study, 2 patients had anterior uveitis, 19 had intermediate uveitis and 2 had panuveitis. The probability of reactivation-free survival after MPS initiation was estimated as 65% at both 1 and 2 years. The probability of discontinuing systemic corticosteroids after 1 year of treatment was 39% and after 2 years 51%. The probability to taper corticosteroids to a daily dosage of ≤0.1 mg/kg after 1 and 2 years was 62% and 85%, respectively. BCVA improved or remained stable in 96% of eyes after 1 year of therapy. Treatment-related side effects were found in nine children (rate: 0.17/patient-year). No therapy discontinuation because of side effects was needed.

Conclusion: Our data suggest that MPS is useful and well tolerated in children with chronic uveitis. MPS seems to be an effective drug for the treatment of chronic non-infectious uveitis of childhood and may be preferred as a first-line steroid-sparing agent in this form of uveitis.

Keywords: Child health (paediatrics); Inflammation; Treatment Medical.

MeSH terms

  • Adolescent
  • Antibiotics, Antineoplastic / administration & dosage
  • Child
  • Chronic Disease
  • Dose-Response Relationship, Drug
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Mycophenolic Acid / administration & dosage*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Uveitis / diagnosis
  • Uveitis / drug therapy*
  • Visual Acuity*

Substances

  • Antibiotics, Antineoplastic
  • Mycophenolic Acid