Transplant rejection drug holds promise for inflammatory eye disease

The immunosuppressive drug mycophenolate mofetil, used to prevent rejection of transplanted hearts, kidneys and livers, may also be effective in controlling inflammatory eye diseases, according to a study by researchers at Johns Hopkins’ Wilmer Eye Institute.

“The drug seemed to be effective even in patients who had failed treatment from other immunosuppressive drugs,” says lead author Jennifer E. Thorne, M.D., an assistant professor of ophthalmology.

Physicians gave the drug to 84 patients, of whom 61 percent had uveitis (intraocular inflammation), 17 percent had scleritis (inflammation of the outer wall of the eye), 11 percent had mucous membrane pemphigoid (a condition causing scarring of the eyelids) and 11 percent had inflammation behind the eye or in other areas. Patients took two pills each morning and two each evening, for a total dose of 2 grams daily. Thirty-six patients (43 percent) already had been treated with at least one other immunosuppressive drug.

Study results, published in the August issue of the journal Ophthalmology, showed that 81 patients (97 percent) had control of their ocular inflammation after one month of treatment. Eighty-two percent of patients had control of their inflammation and were able to taper their dose of the steroid prednisone to 10 or fewer milligrams daily.

Only seven patients discontinued the drug due to side effects such as stomach upset or mild diarrhea. In most cases, Thorne says, lowering the dose of medication can reduce side effects. The drug dosage often can then be increased without the side effects returning.