Mycophenolate mofetil may be effective in CNS sarcoidosis but not in sarcoid myopathy
| Autor: | Sandra Vukusic, D. Maillet, Romain Marignier, L. Pinède, Christian Confavreux, Pascal Sève, Géraldine Androdias, Christiane Broussolle |
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| Přispěvatelé: | Equipe 1, Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Laboratoire Énergies et Mécanique Théorique et Appliquée (LEMTA ), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS)-Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Centre de résonance magnétique biologique et médicale (CRMBM), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Neuro-oncologie et neuro-inflammation, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Equipe 14, Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS) |
| Rok vydání: | 2011 |
| Předmět: |
MESH: Sarcoidosis
Adult Male medicine.medical_specialty Sarcoidosis medicine.drug_class [SDV.CAN]Life Sciences [q-bio]/Cancer Mycophenolate Gastroenterology 03 medical and health sciences 0302 clinical medicine Maintenance therapy Muscular Diseases Central Nervous System Diseases Internal medicine medicine Humans 030212 general & internal medicine MESH: Treatment Outcome MESH: Mycophenolic Acid Aged Retrospective Studies MESH: Aged MESH: Humans business.industry MESH: Muscular Diseases Neurosarcoidosis Retrospective cohort study MESH: Adult MESH: Retrospective Studies Mycophenolic Acid medicine.disease MESH: Central Nervous System Diseases MESH: Male 3. Good health Surgery Prior Therapy Treatment Outcome Corticosteroid Female Neurology (clinical) MESH: Immunosuppressive Agents business MESH: Female 030217 neurology & neurosurgery Immunosuppressive Agents Hormone |
| Zdroj: | Neurology Neurology, American Academy of Neurology, 2011, 76 (13), pp.1168-72. ⟨10.1212/WNL.0b013e318212aafb⟩ Neurology, 2011, 76 (13), pp.1168-72. ⟨10.1212/WNL.0b013e318212aafb⟩ |
| ISSN: | 1526-632X 0028-3878 |
| DOI: | 10.1212/WNL.0b013e318212aafb⟩ |
| Popis: | International audience; OBJECTIVE: To describe effectiveness, steroid-sparing effect, and tolerance of the antiproliferative immunosuppressant mycophenolate mofetil (MMF) in neurosarcoidosis. METHODS: We describe a retrospective case series of 10 consecutive patients with a diagnosis of neurosarcoidosis who were treated with MMF, alone or in association with corticosteroids, in our teaching hospital. RESULTS: At the time of our study, the mean duration of MMF treatment was 21 months. All but one patient with CNS involvement (n = 8) were in remission (except for hormonal dysfunction) which was complete in 6 patients. MMF was efficient as single-agent induction therapy in one patient. The 3 patients who received MMF as a maintenance therapy after initial response to corticosteroids did not relapse even though steroids were stopped. Out of 4 subjects who demonstrated insufficient response to prior therapy including corticosteroids and immunosuppressive agents, 3 demonstrated significant clinical and radiologic improvement. However, the 2 patients who presented muscular sarcoidosis did not respond to MMF. Among patients treated with steroids at MMF introduction and after excluding those with sarcoid myopathy, the mean dose of corticosteroids was 6 mg/day at the end of the follow-up while it was 59 mg/day at the initiation of MMF. No significant side effects were observed. CONCLUSIONS: These data suggest that MMF is effective in CNS sarcoidosis but not in sarcoid myopathy, with a corticosteroid sparing effect and a better tolerance profile than other immunosuppressive agents. |
| Databáze: | OpenAIRE |
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