title: Mycophenolate mofetil in multiple sclerosis: a multicentre retrospective study on 344 patients.
abstract: OBJECTIVE
  Mycophenolate mofetil (MMF) is an immunosuppressive agent, sometimes used as a disease-modifying therapy for multiple sclerosis (MS). Several studies have reported the relative safety of this treatment but, to date, its efficacy has rarely been described. We performed a retrospective study to assess the safety and efficacy of MMF in patients with MS.
  
  
  METHODS
  Three French MS centres included all of their patients 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 patients were included; 149 patients 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 patients without previous immunosuppressant treatment, EDSS remained stable between initiation and 1 year after the beginning of MMF.
  
  
  CONCLUSIONS
  Our results suggest that MMF can improve or stabilise MS patients and can be used as an alternative therapy.
authors.affiliation: Service de Neurologie, CHU Nantes, , Nantes, France.
authors.forename: L
authors.initials: L
authors.lastname: Michel
authors.forename: S
authors.initials: S
authors.lastname: Vukusic
authors.forename: J
authors.initials: J
authors.lastname: De Seze
authors.forename: F
authors.initials: F
authors.lastname: Ducray
authors.forename: J C
authors.initials: JC
authors.lastname: Ongagna
authors.forename: F
authors.initials: F
authors.lastname: Lefrère
authors.forename: M
authors.initials: M
authors.lastname: Jacq-Foucher
authors.forename: C
authors.initials: C
authors.lastname: Confavreux
authors.forename: S
authors.initials: S
authors.lastname: Wiertlewski
authors.forename: D A
authors.initials: DA
authors.lastname: Laplaud
mesh_terms: D000328:Adult; D003520:Cyclophosphamide / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008942:Mitoxantrone / Q000627:therapeutic use; D009103:Multiple Sclerosis / Q000188:drug therapy*; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012189:Retrospective Studies; D055502:Secondary Prevention; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D008942:Mitoxantrone; D009173:Mycophenolic Acid
keywords: Multiple Sclerosis