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.
Fred Hutch/University of Washington Cancer Consortium, Seattle, Washington, United States
Comprehensive Cancer Center of Wake Forest University, Winston-Salem, North Carolina, United States
Columbia University - Herbert Irving Pavilion, New York, New York, United States
University of Cincinnati, Cincinnati, Ohio, United States
University of Pittsburgh Cancer Institute (UPCI), Pittsburgh, Pennsylvania, United States
Fred Hutch/University of Washington Cancer Consortium, Seattle, Washington, United States
University of Florida College of Medicine (Shands), Gainesville, Florida, United States
Virginia Commonwealth University MCV Hospitals, Richmond, Virginia, United States
University of North Carolina Hospital at Chapel Hill, Chapel Hill, North Carolina, United States
St. Jude Children's Research Hospital, Memphis, Tennessee, United States
University of California, San Francisco, San Francisco, California, United States
Mayo Clinic, Rochester, Minnesota, United States
Northwestern University, Chicago, Illinois, United States
Case Comprehensive Cancer Center, Cleveland, Ohio, United States
Johns Hopkins Hospital, Baltimore, Maryland, United States
Washington University in St. Louis, Saint Louis, Missouri, United States
British Columbia Children's Hospital, Vancouver, British Columbia, Canada
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