REVIEW - CellCept for non-renal manifestations of SLE

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Scand J Rheumatol. 2007 Sep-Oct;36(5):329-37.

Mycophenolate mofetil for non-renal manifestations of systemic lupus

erythematosus: a systematic review.

Mok CC.

Department of Medicine, Tuen Mun Hospital, Hong Kong, SAR China.

OBJECTIVE: To summarize the evidence for the use of mycophenolate

mofetil (MMF) in non-renal manifestations of systemic lupus

erythematosus (SLE). METHODS: Treatment trials in human SLE from 1990

to 2006 that have been published in the English literature were

searched by Medline using the keywords 'lupus', 'mycophenolate',

'neuropsychiatric', 'neurological', 'hematological', 'dermatological',

'cutaneous', 'skin', 'hemolytic' and 'thrombocytopenia'. Laboratory

studies were excluded. RESULTS: Twenty relevant studies were

summarized. All were case series or open-labelled trials. The main

indications for MMF were refractory haematological and dermatological

lupus. Data regarding MMF in neuropsychiatric SLE were scant.

Favourable results were reported with haematological disease. Evidence

regarding the efficacy of MMF in refractory lupus skin lesions was

conflicting. The efficacy of MMF in neuropsychiatric lupus was only

modest and could not be separated from that of concomitant therapies.

In one uncontrolled study, MMF was reported to be effective in

preventing clinical flares in patients with persistently active

serological markers. MMF was well tolerated in these reports.

CONCLUSIONS: Limited evidence suggests that MMF may be effective in

refractory haematological and dermatological manifestations of SLE.

Because of the possibility of publication bias, the efficacy of MMF in

these manifestations has to be confirmed with controlled trials. The

efficacy of MMF in neuropsychiatric SLE is unproven and should be

restricted to those patients who are refractory and intolerant to, or

reluctant for, cyclophosphamide. Finally, the current level of

evidence does not support treating serology alone in SLE by MMF.

PMID: 17963161

http://www.ncbi.nlm.nih.gov/pubmed/17963161

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Not an MD