Low-Dose Mycophenolate Mofetil for Treatment of Neuromyelitis Optica Spectrum Disorders: A Prospective Multicenter Study in South China
Objective: To evaluate the efficacy and safety of low-dose mycophenolate mofetil (MMF, 1,000 mg/day) treatment of neuromyelitis optica spectrum disorders (NMOSDs).Methods: This study was a multicenter, open, prospective, follow-up clinical trial. The data include retrospective clinical data from the...
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Frontiers Media S.A.
2018-09-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fimmu.2018.02066/full |
| _version_ | 1819267739030650880 |
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| author | Qiao Huang Qiao Huang Jingqi Wang Yifan Zhou Hui Yang Zhanhang Wang Zhenwen Yan Youming Long Jia Yin Huiyu Feng Caixia Li Zhengqi Lu Xueqiang Hu Wei Qiu |
| author_facet | Qiao Huang Qiao Huang Jingqi Wang Yifan Zhou Hui Yang Zhanhang Wang Zhenwen Yan Youming Long Jia Yin Huiyu Feng Caixia Li Zhengqi Lu Xueqiang Hu Wei Qiu |
| author_sort | Qiao Huang |
| collection | DOAJ |
| description | Objective: To evaluate the efficacy and safety of low-dose mycophenolate mofetil (MMF, 1,000 mg/day) treatment of neuromyelitis optica spectrum disorders (NMOSDs).Methods: This study was a multicenter, open, prospective, follow-up clinical trial. The data include retrospective clinical data from the pretreatment phase and prospective data from the post-treatment phase. From September 2014 to February 2017, NMOSD patients seropositive for aquaporin 4-IgG (AQP4-IgG) were treated with low-dose MMF.Results: Ninety NMOSD patients were treated with MMF for a median duration of 18 months (range 6–40 months). The median annual recurrence rate (ARR) decreased from 1.02 before treatment to 0 (P < 0.0001) after treatment, and the Expanded Disability Status Scale (EDSS) score decreased from 4 to 3 (P < 0.0001). The EDSS score was significantly lower (P = 0.038) after the first 90 days of treatment. The serum AQP4-IgG titer decreased in 50 cases (63%). The median Simple McGill pain score (SF-MPQ) was reduced in 65 patients (88%) with myelitis from 17 (range 0–35) to 11 (range 0–34) after treatment (P < 0.0001). The median Hauser walking index (Hauser Walk Rating Scale) was reduced from 2 (range 1–9) before treatment to 1 (range 0–7) after treatment (P < 0.0001). Adverse events were documented in 43% of the patients, and eight patients discontinued MMF due to intolerable adverse events. Fourteen (16%) of the total patients discontinued MMF after our last follow-up for various reasons and switched to azathioprine or rituximab.Conclusion: Low-dose MMF reduced clinical relapse and disability in NMOSD patients in South China. However, some patients still suffered from adverse events at this dosage.Clinical Trial Registration: www.ClinicalTrials.gov, identifier : NCT02809079. |
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| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-12-23T21:21:57Z |
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| spelling | doaj.art-bfe2c95b39a34d37bd0075e4fc9435662022-12-21T17:30:44ZengFrontiers Media S.A.Frontiers in Immunology1664-32242018-09-01910.3389/fimmu.2018.02066404516Low-Dose Mycophenolate Mofetil for Treatment of Neuromyelitis Optica Spectrum Disorders: A Prospective Multicenter Study in South ChinaQiao Huang0Qiao Huang1Jingqi Wang2Yifan Zhou3Hui Yang4Zhanhang Wang5Zhenwen Yan6Youming Long7Jia Yin8Huiyu Feng9Caixia Li10Zhengqi Lu11Xueqiang Hu12Wei Qiu13Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaDepartment of Neurology, Zhaoqing No. 2 People's Hospital, Zhaoqing, ChinaDepartment of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaDepartment of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaDepartment of Neuro-Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, ChinaDepartment of Neurology, Guangdong 999 Brain Hospital, Guangzhou, ChinaDepartment of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Neurology, Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaDepartment of Neurology, Nanfang Hospital, Guangzhou, ChinaDepartment of Neurology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaSchool of Mathematics, Sun Yat-sen University, Guangzhou, ChinaDepartment of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaDepartment of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaDepartment of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaObjective: To evaluate the efficacy and safety of low-dose mycophenolate mofetil (MMF, 1,000 mg/day) treatment of neuromyelitis optica spectrum disorders (NMOSDs).Methods: This study was a multicenter, open, prospective, follow-up clinical trial. The data include retrospective clinical data from the pretreatment phase and prospective data from the post-treatment phase. From September 2014 to February 2017, NMOSD patients seropositive for aquaporin 4-IgG (AQP4-IgG) were treated with low-dose MMF.Results: Ninety NMOSD patients were treated with MMF for a median duration of 18 months (range 6–40 months). The median annual recurrence rate (ARR) decreased from 1.02 before treatment to 0 (P < 0.0001) after treatment, and the Expanded Disability Status Scale (EDSS) score decreased from 4 to 3 (P < 0.0001). The EDSS score was significantly lower (P = 0.038) after the first 90 days of treatment. The serum AQP4-IgG titer decreased in 50 cases (63%). The median Simple McGill pain score (SF-MPQ) was reduced in 65 patients (88%) with myelitis from 17 (range 0–35) to 11 (range 0–34) after treatment (P < 0.0001). The median Hauser walking index (Hauser Walk Rating Scale) was reduced from 2 (range 1–9) before treatment to 1 (range 0–7) after treatment (P < 0.0001). Adverse events were documented in 43% of the patients, and eight patients discontinued MMF due to intolerable adverse events. Fourteen (16%) of the total patients discontinued MMF after our last follow-up for various reasons and switched to azathioprine or rituximab.Conclusion: Low-dose MMF reduced clinical relapse and disability in NMOSD patients in South China. However, some patients still suffered from adverse events at this dosage.Clinical Trial Registration: www.ClinicalTrials.gov, identifier : NCT02809079.https://www.frontiersin.org/article/10.3389/fimmu.2018.02066/fullneuromyelitis optica spectrum disordersmycophenolate mofetiltherapya prospective studySouth China |
| spellingShingle | Qiao Huang Qiao Huang Jingqi Wang Yifan Zhou Hui Yang Zhanhang Wang Zhenwen Yan Youming Long Jia Yin Huiyu Feng Caixia Li Zhengqi Lu Xueqiang Hu Wei Qiu Low-Dose Mycophenolate Mofetil for Treatment of Neuromyelitis Optica Spectrum Disorders: A Prospective Multicenter Study in South China Frontiers in Immunology neuromyelitis optica spectrum disorders mycophenolate mofetil therapy a prospective study South China |
| title | Low-Dose Mycophenolate Mofetil for Treatment of Neuromyelitis Optica Spectrum Disorders: A Prospective Multicenter Study in South China |
| title_full | Low-Dose Mycophenolate Mofetil for Treatment of Neuromyelitis Optica Spectrum Disorders: A Prospective Multicenter Study in South China |
| title_fullStr | Low-Dose Mycophenolate Mofetil for Treatment of Neuromyelitis Optica Spectrum Disorders: A Prospective Multicenter Study in South China |
| title_full_unstemmed | Low-Dose Mycophenolate Mofetil for Treatment of Neuromyelitis Optica Spectrum Disorders: A Prospective Multicenter Study in South China |
| title_short | Low-Dose Mycophenolate Mofetil for Treatment of Neuromyelitis Optica Spectrum Disorders: A Prospective Multicenter Study in South China |
| title_sort | low dose mycophenolate mofetil for treatment of neuromyelitis optica spectrum disorders a prospective multicenter study in south china |
| topic | neuromyelitis optica spectrum disorders mycophenolate mofetil therapy a prospective study South China |
| url | https://www.frontiersin.org/article/10.3389/fimmu.2018.02066/full |
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