A real-world assessment of mycophenolate mofetil for remission-induction in eosinophilic granulomatosis with polyangiitis

Philobos, M., Perkins, A., Karabyas, M., Dospinescu, P., Fluck, N., Kidder, D., Chapman, F., Dhaun, N. and Basu, N. (2021) A real-world assessment of mycophenolate mofetil for remission-induction in eosinophilic granulomatosis with polyangiitis. Rheumatology International, 41(10), pp. 1811-1814. (doi: 10.1007/s00296-021-04961-w) (PMID:34350491)

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Abstract

Eosinophilic granulomatosis with polyangiitis (EGPA) is a form of ANCA-associated vasculitis (AAV). Clinical trials demonstrating the efficacy of mycophenolate mofetil (MMF) for remission induction in AAV excluded patients with EGPA. Despite this, MMF is commonly used in these patients. The objective of this study was to evaluate, for the first time, the effectiveness and tolerance of MMF in EGPA remission induction. A retrospective, two-center, real-world study was conducted in patients with EGPA who received MMF in addition to prednisolone for newly diagnosed or relapsing disease between 2009 and 2019. Baseline, 3-, 6- and 12-month outcome data were extracted from electronic health records. The primary outcome was disease remission, defined as a Birmingham Vasculitis Activity Score of 0 at 6 months. Secondary outcomes included disease relapse, median prednisolone dose at 12 months and drug tolerance. In total, 15 patients (73% male, median age 57) with EGPA (11 newly diagnosed/4 relapsing) were identified. At 6 months, 67% had achieved disease remission. At 12 months, this was maintained (66.7%) and 4 patients had relapsed. All but one patient remained on MMF at study completion and all patients tolerated MMF. Our real-world data suggest that MMF is an effective and well-tolerated agent for achieving disease remission in EGPA. A future randomized controlled trial of MMF in this neglected orphan disease is now warranted.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Basu, Professor Neil and Perkins, Dr Amy
Authors: Philobos, M., Perkins, A., Karabyas, M., Dospinescu, P., Fluck, N., Kidder, D., Chapman, F., Dhaun, N., and Basu, N.
College/School:College of Medical Veterinary and Life Sciences > Institute of Infection Immunity and Inflammation
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Rheumatology International
Publisher:Springer
ISSN:0172-8172
ISSN (Online):1437-160X
Published Online:04 August 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in Rheumatology International 41(10): 1811-1814
Publisher Policy:Reproduced under a Creative Commons licence

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