mycophenolic-acid and Arthritis--Psoriatic

Psoriatic arthritis is a heterogeneous condition, the pattern of which is determined by any combination of pathology affecting peripheral joints, the enthesis and the spine. There is a paucity of evidence for most of the conventional agents used to treat psoriatic arthritis, with many of them being used on the basis of experience in rheumatoid arthritis. Herein, we summarise the evidence compiled relating to effectiveness of treatment for various manifestation of PsA. For those patients with progressive forms of arthritis who may benefit from intervention of newer biological therapies, the continued use of conventional therapy needs ever increasing scrutiny.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Antirheumatic Agents; Arthritis, Psoriatic; Cyclosporine; Drug Therapy, Combination; Evidence-Based Medicine; Glucocorticoids; Humans; Isoxazoles; Leflunomide; Methotrexate; Mycophenolic Acid; Sulfasalazine; Treatment Outcome

Standard therapies against inflammatory rheumatic diseases consist of immunosuppressive drugs with high toxicities and many side effects. Except in the treatment of systemic lupus erythematosus with renal involvement, controlled studies with mycophenolate mofetil (MMF) are lacking in other autoimmune and inflammatory systemic diseases. Here we describe our clinical experience with MMF in several unusual indications.. We collected data including serological findings, adverse events and response to treatment in eleven patients with autoimmune diseases including systemic lupus erythematosus (SLE), mixed connective tissue disease (MCTD), polymyositis (PM), diffuse systemic sclerosis that were treated in our rheumatology unit.. Our results show remission in ten patients with minimal side effects and reduced prednisone dosage. The median dose of MMF was 2 g per day. Adverse events were limited, with one case of leucopenia, one tachycardia and one colitis. One patient definitively stopped the treatment because of side effects.. MMF seems to be a very powerful and attractive alternative medication in the treatment of immune-mediated inflammatory diseases. The good tolerance and safety profile makes it an excellent therapeutic option permitting a global reduction of corticosteroids doses.

Topics: Adolescent; Adult; Aged; Arthritis, Psoriatic; Female; Humans; Immunosuppressive Agents; Lupus Erythematosus, Systemic; Male; Middle Aged; Mixed Connective Tissue Disease; Mycophenolic Acid; Polymyositis; Retrospective Studies; Scleroderma, Systemic; Young Adult

A case of psoriasis and psoriatic arthritis in a 38-year-old white male patient infected with human immunodeficiency virus (HIV) treated safely and effectively with mycophenolate mofetil (MMF) is reported. Treatments for psoriasis and psoriatic arthritis are manifold, including topical, oral, intramuscular, intravenous, and subcutaneous therapies. These indicated treatments for psoriasis and psoriatic arthritis result in suppression of the immune system.

Topics: Anti-Inflammatory Agents; Anti-Inflammatory Agents, Non-Steroidal; Antiretroviral Therapy, Highly Active; Arthritis, Psoriatic; Clobetasol; HIV Infections; Humans; Male; Middle Aged; Mycophenolic Acid; Psoriasis; Skin

Psoriatic arthritis concerns both the skin and the joints. Therapeutic interventions should therefore ideally improve both symptoms. Current disease modifying drugs are effective; however, they are usually limited to either psoriasis or arthritis.. The aim of this study was to analyze the therapeutic effects of a new immunosuppressive drug (Mycophenolate mofetil) in the treatment of psoriatic arthritis.. Six patients with psoriatic arthritis were treated with Mycophenolate mofetil for a period of 12 weeks and examined every 14 days (range of motion, joint swelling, joint deformity, PASI score (Psoriasis Area and Severity Index). In addition, a life quality assessment (SF-36 Health Survey) was performed. White and red blood count as well as inflammation parameter were controlled regularly.. 6 patients could be included in a complete follow-up (5 men, 1 woman, average age 50.3 years, average duration of psoriasis 8.3 years, average duration of arthritis 5.7 years). Four of 6 patients showed relevant improvement in pain, mobility and degree of psoriatic skin effluorescences. Only 3 of 6 showed relevant improvement in life quality.. For the first time results of treatment of psoriatic arthritis with a new immunosuppressive drug (Mycophenolate mofetil) were presented. A positive influence on both, the arthritis and the psoriasis could be shown. These first observations warrant controlled, randomized clinical trials.

Topics: Adult; Arthritis, Psoriatic; Female; Follow-Up Studies; Humans; Immunosuppressive Agents; Male; Middle Aged; Mycophenolic Acid; Pain Measurement; Pilot Projects; Quality of Life; Treatment Outcome

Mycophenolate mofetil (MMF), a widely used immunosuppressant in organ transplantation, is a recent addition to the therapeutic armamentarium of autoimmune and inflammatory skin disorders in dermatology. We describe 5 patients with moderate to severe chronic plaque psoriasis and 6 patients with psoriatic arthritis that was refractory to conventional systemic and/or topical antipsoriatic treatment who were treated with MMF monotherapy (2 g/d) in a 10-week study. Although MMF was tolerated well in all patients, only patients with moderate psoriasis and psoriatic arthritis improved with therapy, whereas patients with severe psoriasis did not respond to MMF. Although MMF seems to be effective and safe for blistering autoimmune diseases and pyoderma gangrenosum, our data do not allow optimistic statements on the use of MMF in severe plaque-stage psoriasis. However, MMF may develop into an interesting therapeutic alternative for patients with psoriatic arthritis.

Topics: Adult; Arthritis, Psoriatic; Chronic Disease; Female; Humans; Immunosuppressive Agents; Male; Middle Aged; Mycophenolic Acid; Psoriasis

A woman with a long history of widespread plaque psoriasis unresponsive to and/or intolerant of phototherapy, retinoids, methotrexate and cyclosporin was successfully treated with mycophenolate mofetil. Remission was maintained on doses between 1 and 1.5 g/day for 18 months without adverse effects.

Topics: Adult; Arthritis, Psoriatic; Female; Humans; Immunosuppressive Agents; Indomethacin; Mycophenolic Acid; Piroxicam; Prednisone; Psoriasis; Treatment Outcome