Mycophenolate mofetil, also known as MMF or CellCept, is a prodrug of mycophenolic acid, and classified as a reversible inhibitor of inosine monophosphate dehydrogenase (IMPDH). This drug is an immunosuppressant combined with drugs such as Cyclosporine and corticosteroids to prevent organ rejection after hepatic, renal, and cardiac transplants. It is marketed by Roche Pharmaceuticals and was granted FDA approval for the prophylaxis of transplant rejection in 1995. In addition to the above uses, mycophenolate mofetil has also been studied for the treatment of nephritis and other complications of autoimmune diseases. Unlike another immunosuppressant class, the calcineurin inhibitors, MMF generally does not cause nephrotoxicity or fibrosis.
Previously, mycophenolic acid (MPA) was administered to individuals with autoimmune diseases beginning in the 1970s, but was discontinued due to gastrointestinal effects and concerns over carcinogenicity. The new semi-synthetic 2-morpholinoethyl ester of MPA was synthesized to avoid the gastrointestinal effects associated with the administration of MPA. It demonstrates an increased bioavailability, a higher efficacy, and reduced gastrointestinal effects when compared to MPA.
Mycophenolate mofetil is indicated in combination with other immunosuppressants to prevent the rejection of kidney, heart, or liver transplants in adult and pediatric patients ≥3 months old. Mycophenolate mofetil may also be used off-label as a second-line treatment for autoimmune hepatitis that has not responded adequately to first-line therapy. Other off-label uses of this drug include lupus-associated nephritis and dermatitis in children.
Jeroen Bosch Ziekenhuis, Den Bosch, Netherlands
University Hospital Antwerpen, Antwerpen, Belgium
Vrije Universiteit Medisch Centrum, Amsterdam, Netherlands
PGIMER, Chandigarh, India
Memorial Sloan Kettering Cancer Center, New York, New York, United States
North Carolina Cancer Hospital, Chapel Hill, North Carolina, United States
Columbia University Irving Medical Center, New York, New York, United States
Children's National Medical Center, Washington, District of Columbia, United States
Novartis Investigative Site, Lund, Sweden
M D Anderson Cancer Center, Houston, Texas, United States
The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, United States
Clinical Islet Transplant Program, Edmonton, Alberta, Canada
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