Epub: Michel et al. Mycophenolate mofetil in multiple sclerosis: a multicentre retrospective study on 344 patients.J Neurol Neurosurg Psychiatry. 2013 May 23.
OBJECTIVES: Mycophenolate mofetil (MMF) is an immunosuppressive agent, sometimes used as a disease-modifying therapy for MS. Several studies have reported the relative safety of this treatment but, to date, its efficacy has rarely been described. This group performed a retrospective study to assess the safety and efficacy of MMF in MSers.
METHODOLOGY: Three French MS centres included all of their MSers treated by MMF. The main outcome criterion was annualised relapse rate (ARR) in the 1 year period after onset of MMF compared with the 1 year control period. Treatment with another immunosuppressive drug, such as mitoxantrone or cyclophosphamide, in the 2 years preceding initiation of MMF was included in a subgroup analysis. MMF safety and progression of the Expanded Disability Status Scale (EDSS) score were also assessed.
RESULTS: 344 MSers were included; 149 MSers were previously treated with another immunosuppressant (IS group). Mean MMF treatment duration was 25.3±1.1 months. During the 1 year control period, ARR was 1.11±0.08, and for the 1 year treatment period, ARR was reduced significantly to 0.35±0.05 (p<0.0001, Wilcoxon paired test). Adverse events (occurring in 11% of patients) were mainly digestive disorders, benign infections, asthenia and transitory lymphopenia. Concerning the progression of disability, in the subgroup of MSers without previous immunosuppressant treatment, EDSS remained stable between initiation and 1 year after the beginning of MMF.
INTERPRETATION: These results suggest that MMF can improve or stabilise MSers and can be used as an alternative therapy.
The use of CellCept to treat MS, while not exactly common, is not all that unusual here in the US. I gave it a whirl several years ago, but saw no benefit whatsoever. Then again, none of the immunosuppressives have done me any good, so the result wasn't surprising…