Mycophenolate mofetil in giant cell arteritis
IntroductionGiant cell arteritis (GCA) is a systemic granulomatous vasculitis affecting the large arteries. Abnormal lymphocyte function has been noted as a pathogenic factor in GCA. Mycophenolate mofetil (MMF) inhibits inosine monophosphate dehydrogenase and is therefore a highly lymphocyte-specifi...
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Frontiers Media S.A.
2023-11-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1254747/full |
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| author | Anne Pankow Anne Pankow Sena Sinno Thorsten Derlin Marcus Hiss Annette D. Wagner |
| author_facet | Anne Pankow Anne Pankow Sena Sinno Thorsten Derlin Marcus Hiss Annette D. Wagner |
| author_sort | Anne Pankow |
| collection | DOAJ |
| description | IntroductionGiant cell arteritis (GCA) is a systemic granulomatous vasculitis affecting the large arteries. Abnormal lymphocyte function has been noted as a pathogenic factor in GCA. Mycophenolate mofetil (MMF) inhibits inosine monophosphate dehydrogenase and is therefore a highly lymphocyte-specific immunosuppressive therapy. We aimed to assess the efficacy of MMF for inducing remission in GCA.MethodsSeven patients (5 female, 2 male) with GCA under therapy with MMF and who were treated at the outpatient clinic for rare inflammatory systemic diseases at Hannover Medical School between 2010 and 2023 were retrospectively included in the study. All patients underwent duplex sonography, 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET), magnetic resonance imaging (MRI), and/or biopsy to confirm the diagnosis. The primary endpoints were the number of recurrences, CRP levels at 3–6 and 6–12 months, and the period of remission.ResultsAll patients in this case series showed inflammatory activity of the arterial vessels in at least one of the imaging modalities: duplex sonography (n = 5), 18F-FDG PET (n = 5), MRI (n = 6), and/or biopsy (n = 5). CRP levels of all patients decreased at the measurement time points 3–6 months, and 6–9 months after initiation of therapy with MMF compared with CRP levels before MMF therapy. All patients with GCA in this case series achieved disease remission.DiscussionThe results of the present case series indicate that MMF is an effective therapy in controlling disease activity in GCA, which should be investigated in future randomized controlled trials. |
| first_indexed | 2024-03-11T10:56:52Z |
| format | Article |
| id | doaj.art-084d3398a8724940a581c9d92c9177cd |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-11T10:56:52Z |
| publishDate | 2023-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-084d3398a8724940a581c9d92c9177cd2023-11-13T04:39:22ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-11-011010.3389/fmed.2023.12547471254747Mycophenolate mofetil in giant cell arteritisAnne Pankow0Anne Pankow1Sena Sinno2Thorsten Derlin3Marcus Hiss4Annette D. Wagner5Department of Rheumatology and Clinical Immunology, Charité – Universitätsmedizin Berlin, Berlin, GermanyDepartment of Nephrology, Hannover Medical School, Hanover, GermanyDepartment of Nephrology, Hannover Medical School, Hanover, GermanyDepartment of Nuclear Medicine, Hannover Medical School, Hanover, GermanyDepartment of Nephrology, Hannover Medical School, Hanover, GermanyDepartment of Nephrology, Hannover Medical School, Hanover, GermanyIntroductionGiant cell arteritis (GCA) is a systemic granulomatous vasculitis affecting the large arteries. Abnormal lymphocyte function has been noted as a pathogenic factor in GCA. Mycophenolate mofetil (MMF) inhibits inosine monophosphate dehydrogenase and is therefore a highly lymphocyte-specific immunosuppressive therapy. We aimed to assess the efficacy of MMF for inducing remission in GCA.MethodsSeven patients (5 female, 2 male) with GCA under therapy with MMF and who were treated at the outpatient clinic for rare inflammatory systemic diseases at Hannover Medical School between 2010 and 2023 were retrospectively included in the study. All patients underwent duplex sonography, 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET), magnetic resonance imaging (MRI), and/or biopsy to confirm the diagnosis. The primary endpoints were the number of recurrences, CRP levels at 3–6 and 6–12 months, and the period of remission.ResultsAll patients in this case series showed inflammatory activity of the arterial vessels in at least one of the imaging modalities: duplex sonography (n = 5), 18F-FDG PET (n = 5), MRI (n = 6), and/or biopsy (n = 5). CRP levels of all patients decreased at the measurement time points 3–6 months, and 6–9 months after initiation of therapy with MMF compared with CRP levels before MMF therapy. All patients with GCA in this case series achieved disease remission.DiscussionThe results of the present case series indicate that MMF is an effective therapy in controlling disease activity in GCA, which should be investigated in future randomized controlled trials.https://www.frontiersin.org/articles/10.3389/fmed.2023.1254747/fullMycophenolate mofetilgiant cell arteritisvasculitiscase seriesimaging |
| spellingShingle | Anne Pankow Anne Pankow Sena Sinno Thorsten Derlin Marcus Hiss Annette D. Wagner Mycophenolate mofetil in giant cell arteritis Frontiers in Medicine Mycophenolate mofetil giant cell arteritis vasculitis case series imaging |
| title | Mycophenolate mofetil in giant cell arteritis |
| title_full | Mycophenolate mofetil in giant cell arteritis |
| title_fullStr | Mycophenolate mofetil in giant cell arteritis |
| title_full_unstemmed | Mycophenolate mofetil in giant cell arteritis |
| title_short | Mycophenolate mofetil in giant cell arteritis |
| title_sort | mycophenolate mofetil in giant cell arteritis |
| topic | Mycophenolate mofetil giant cell arteritis vasculitis case series imaging |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1254747/full |
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