Mycophenolate mofetil is ineffective in the treatment of mucocutaneous Adamantiades-Behçet's disease.
BACKGROUND
Cyclosporine A and azathioprine are effective on mucocutaneous lesions in Adamantiades-Behçet'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-Behçet'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 Behçet'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.


CONCLUSIONS
MMF (2-3 g/day) is unable to control the signs of mucocutaneous Adamantiades-Behçet's disease.
Adler
Y D
YD
Department of Dermatology, University Medical Center Benjamin Franklin, The Free University of Berlin, Germany.
Mansmann
U
U
Zouboulis
C C
CC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001528:Behcet Syndrome / Q000188:drug therapy*; D002648:Child; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D011239:Prednisolone / Q000627:therapeutic use; D017211:Treatment Failure
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D011239:Prednisolone; D009173:Mycophenolic Acid