Real-world use of mycophenolate mofetil in inflammatory bowel disease: Results from the ENEIDA registry.

Chronic Disease Colitis, Ulcerative / drug therapy Crohn Disease / drug therapy Humans Inflammatory Bowel Diseases / drug therapy Mycophenolic Acid / therapeutic use Registries

Crohn's disease Inflammatory bowel disease Mycophenolate mofetil Ulcerative colitis

Journal

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver

ISSN: 1878-3562

Titre abrégé: Dig Liver Dis

Pays: Netherlands

ID NLM: 100958385

Informations de publication

Date de publication:
05 2022

Historique:

received: 11 05 2021

revised: 22 09 2021

accepted: 07 10 2021

pubmed: 5 12 2021

medline: 3 5 2022

entrez: 4 12 2021

Statut: ppublish

Résumé

Studies to evaluate the use of mycophenolate mofetil (MMF) in inflammatory bowel disease (IBD) are limited after the appearance of biological treatments. Our primary objective was to evaluate the effectiveness and safety of MMF in IBD. IBD patients who had received MMF were retrieved from the ENEIDA registry. Clinical activity as per the Harvey-Bradshaw Index (HBI), partial Mayo score (pMS), physician global assessment (PGA) and C-reactive protein (CRP) were reviewed at baseline, at 3 and 6 months, and at final follow-up. Adverse events and causes of treatment discontinuation were documented. A total of 83 patients were included (66 Crohn's disease, 17 ulcerative colitis), 90% of whom had previously received other immunosuppressants. In 61% of patients systemic steroids were used at initiation of MMF, and in 27.3% biological agents were co-administered with MMF. Overall clinical effectiveness was observed in 64.7% of the population. At the end of treatment, 45.6% and 19.1% of subjects showed remission and clinical response, respectively. MMF treatment was maintained for a median of 28.9 months (IQR: 20.4-37.5). Our study suggests, in the largest cohort to date, that MMF may be an effective alternative to thiopurines and methotrexate in IBD.

Sections du résumé

BACKGROUND

Studies to evaluate the use of mycophenolate mofetil (MMF) in inflammatory bowel disease (IBD) are limited after the appearance of biological treatments.

AIMS

Our primary objective was to evaluate the effectiveness and safety of MMF in IBD.

METHODS

IBD patients who had received MMF were retrieved from the ENEIDA registry. Clinical activity as per the Harvey-Bradshaw Index (HBI), partial Mayo score (pMS), physician global assessment (PGA) and C-reactive protein (CRP) were reviewed at baseline, at 3 and 6 months, and at final follow-up. Adverse events and causes of treatment discontinuation were documented.

RESULTS

A total of 83 patients were included (66 Crohn's disease, 17 ulcerative colitis), 90% of whom had previously received other immunosuppressants. In 61% of patients systemic steroids were used at initiation of MMF, and in 27.3% biological agents were co-administered with MMF. Overall clinical effectiveness was observed in 64.7% of the population. At the end of treatment, 45.6% and 19.1% of subjects showed remission and clinical response, respectively. MMF treatment was maintained for a median of 28.9 months (IQR: 20.4-37.5).

CONCLUSION

Our study suggests, in the largest cohort to date, that MMF may be an effective alternative to thiopurines and methotrexate in IBD.

Identifiants

DOI: 10.1016/j.dld.2021.10.002 PMID: 34862115

pubmed: 34862115

pii: S1590-8658(21)00807-0

doi: 10.1016/j.dld.2021.10.002

pii:

doi:

Substances chimiques

Mycophenolic Acid HU9DX48N0T

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

635-641

Investigateurs

O Merino (O)