Mycophenolate mofetil is ineffective in the treatment of mucocutaneous Adamantiades-Behcet's disease

被引:41
作者
Adler, YD
Mansmann, U
Zouboulis, CC
机构
[1] Free Univ Berlin, Dept Dermatol, Med Ctr Benjamin Franklin, D-14195 Berlin, Germany
[2] Free Univ Berlin, Inst Med Informat Biometry & Epidemiol, Med Ctr Benjamin Franklin, D-14195 Berlin, Germany
关键词
Behcet's disease; mycophenolate mofetil; interferon alpha;
D O I
10.1159/000051781
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Background. Cyclosporine A and azathioprine are effective on mucocutaneous lesions in Adamantiades-Behcet's disease. Mycophenolate mofetil (MMF) is a drug resembling their activity but with comparably negligible adverse reactions. Objective: A prospective clinical proof-of-principle study was conducted to investigate the effectiveness and toxicity of MMF in mucocutaneous Adamantiades-Behcet's disease. Methods: Thirty patients were to be treated with MMF 2 g/day p.o. for 6 months, in combination with prednisolone 30 mg/day p.o. during the first month of treatment. Inefficacy was followed by an increase in MMF dose to 3 g/day. The primary efficacy variable was the decrease in the disease activity index (DAI) according to a modified variant of the Iran Behcet's Disease Dynamic Activity Measure system. Results: The study was interrupted due to inefficacy of the compound after the intermediate evaluation of the first 6 patients (aged 37.0 +/- 7.7 years with disease duration of 10.0 +/- 8.9 years) as required by the ethical committee. Although an improvement of the DAI from 5.2 +/- 3.5 to 1.3 +/- 0.5 was found after the first month of combination treatment, withdrawal of prednisolone led to quick relapses with a new index increase (3.0 +/- 3.5). The treatment was discontinued in 3 patients after 3 months, in 2 patients after 4 months and in another one after 5 months due to deterioration of the disease. Introduction of interferon alpha(2a) (3 x 9 million IU: 3x/week s.c.) in 3 patients decreased the activity index from 4.0 +/- 1.0 to 0.0 +/- 0.0. No adverse effects were detected under MMF treatment. Conclusion: MMF (2-3 g/day) is unable to control the signs of mucocutaneous Adamantiades-Behcet's disease. Copyright (C) 2001 S. Karger AG, Basel.
引用
收藏
页码:322 / 324
页数:3
相关论文
共 13 条
[1]  
ALLISON AC, 1991, TRANSPL P, V23, P10
[2]  
ALLISON AC, 1993, CLIN TRANSPLANT, V7, P96
[3]  
DAVATCHI F, 1993, INT CONGR SER, V1037, P225
[4]  
DAVATCHI F, 1991, HUNG RHEUMATOL S, V32, pF10
[5]   Antiinflammatory properties of mycophenolate mofetil in murine endotoxemia:: inhibition of TNF-α and upregulation of IL-10 release [J].
Durez, P ;
Appelboom, T ;
Pira, C ;
Stordeur, E ;
Vray, B ;
Goldman, M .
INTERNATIONAL JOURNAL OF IMMUNOPHARMACOLOGY, 1999, 21 (09) :581-587
[6]  
Eksioglu-Demiralp E, 1999, J RHEUMATOL, V26, P826
[7]   Increased CD4+CD16+ and CD4+CD56+ T cell subsets in Behcet's disease [J].
Eksioglu-Demiralp, E ;
Direskeneli, H ;
Ergun, T ;
Fresko, I ;
Akoglu, T .
RHEUMATOLOGY INTERNATIONAL, 1999, 19 (1-2) :23-26
[8]   Neutrophil adhesion to endothelial cells and factors affecting adhesion in patients with Behcet's disease [J].
Sahin, S ;
Akoglu, T ;
Direskeneli, H ;
Sen, LS ;
Lawrence, R .
ANNALS OF THE RHEUMATIC DISEASES, 1996, 55 (02) :128-133
[9]  
Sayinalp N, 1996, J RHEUMATOL, V23, P321
[10]  
SUSS R, 1993, J AM ACAD DERMATOL, V29, P101