Mycophenolate mofetil as a systemic antipsoriatic agent: positive experience in 11 patients

Abstract

Background Mycophenolate mofetil (MMF) is a novel immunosuppressive drug. Several case reports have suggested that MMF has a beneficial effect in patients with psoriasis and autoimmune dermatoses. Objectives To investigate the efficacy and safety of oral MMF in severe psoriasis. Methods Eleven patients with severe stable plaque‐type psoriasis and a Psoriasis Area and Severity Index (PASI) between 12 and 53 (mean 30·5) were included in the study. They received oral MMF 1 g twice daily for 3 weeks and then 0·5 g twice daily for 3 weeks. The PASI were determined at baseline (week 0) and after 1, 2, 3 and 6 weeks of treatment. Results Within 3 weeks of this therapy there was a reduction in PASI of between 40% and 70% in seven of 11 patients, and only one patient achieved a reduction in PASI of < 25% from baseline (mean PASI 15·6). Reducing MMF from 2 g daily to 1 g daily led to further, although only slight, improvement in six of 11 patients during the following 3 weeks. In four of 11 patients, the PASI increased at this lower dosage, and in one patient the drug was withdrawn because of muscle pain, which was possibly drug induced. This side‐effect reversed within a few days after stopping the drug. Other side‐effects, especially gastrointestinal and haematological toxicity, were not observed in any of the 11 patients treated. Overall, the mean PASI was 16·1 after 6 weeks. Conclusions We conclude that the immunosuppressant MMF 2 g daily is effective and safe in the treatment of severe psoriasis.