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Title: Mycophenolate mofetil substitution for cyclosporine-dependent myasthenia gravis and nephrotoxicity.
Austin Authors: Lim, A K H;Donnan, Geoffrey A ;Chambers, Brian R ;Ierino, F L
Affiliation: Department of Nephrology, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 1-Jan-2007
Publication information: Internal Medicine Journal; 37(1): 55-9
Abstract: Severe autoimmune myasthenia gravis is difficult to manage and may require immunosuppression with cyclosporine. However, cyclosporine dependency is associated with the risk of nephrotoxicity. Mycophenolate mofetil is a non-nephrotoxic alternative which should be considered to rescue cyclosporine-dependent, severe myasthenia gravis sufferers with renal impairment from progression to end-stage renal failure. However, the evidence is limited and studies have not assessed the outcome of a direct substitution in these cyclosporine-dependent patients. We study three such patients who successfully converted to mycophenolate mofetil, and briefly examine the evidence behind this option. We believe that total cyclosporine withdrawal is feasible, but strongly recommend overlapping mycophenolate mofetil treatment with cyclosporine.
Gov't Doc #: 17199845
DOI: 10.1111/j.1445-5994.2006.01222.x
Type: Journal Article
Subjects: Adult
Cyclosporine.adverse effects.therapeutic use
Diabetic Nephropathies.chemically induced.complications
Drug Evaluation
Hypertension, Renal.chemically induced
Immunosuppressive Agents.adverse effects.therapeutic use
Kidney Diseases.blood.chemically induced.complications
Kidney Failure, Chronic.etiology
Middle Aged
Myasthenia Gravis.drug
Mycophenolic Acid.analogs & derivatives.therapeutic use
Plasma Exchange
Prednisolone.adverse effects.therapeutic use
Appears in Collections:Journal articles

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