Mycophenolate mofetil in the treatment of non-renal manifestations of systemic lupus erythematosus: recent insights

Mycophenolate mofetil (MMF) is an immunosuppressive agent that has been shown to beeffective in transplant patients. It is also efficacious in the management of lupus nephritis, anduseful in the treatment of autoimmune conditions as its mechanisms of action target the T- andB – lymphocytes, leading to suppression of the cell-mediated 3immune responses and antibodyformation. It has been used successfully in immune-mediated conditions like myasthenia gravis,autoimmune hepatitis and immune cytopenias. However, its optimal use in non-renalmanifestations (hematological, neuropsychiatric, myocardial, pulmonary, cutaneous etc.) inlupus patients is unclear. There are yet to be randomised controlled trials to guide the optimaldoses and durations of MMF in such situations. MMF is well tolerated and safe to use, thoughthere are reports of serious adverse effects like urticaria, myopathy, Epstein-Barr virus-associatedB-cell lymphoma, cytomegalovirus infections and disseminated varicella zoster. Another areaof concern for patients is the increased cost of using long-term MMF.Key words: systemic lupus erythematosus, mycophenolate mofetil, treatment