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.
Masonic Cancer Center at University of Minnesota, Minneapolis, Minnesota, United States
Peking Union Medical College Hospital, Beijing, China
Institut Universitaire de Cardiologie et Pneumologie de Québec, Quebec City, Quebec, Canada
Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada
Jewish General Hospital - CIUSSS-COMTL, Montreal, Quebec, Canada
Memorial Sloan Kettering Bergen (Consent only), Montvale, New Jersey, United States
Memorial Sloan Kettering Monmouth (Consent only), Middletown, New Jersey, United States
Memorial Sloan Kettering at Basking Ridge (Consent only), Basking Ridge, New Jersey, United States
Department of Rheumatology and Immunology, Xiangya Second Hospital, Central South University, Changsha, Hunan, China
xiaomin Zhang, Tianjin, Tianjin, China
Froedtert Hospital & the Medical College of Wisconsin, Milwaukee, Wisconsin, United States
Kerckhoff-Klinik GmbH, Bad Nauheim, Germany
Charité - University Hospital Berlin, Berlin, Germany
UHF- Universitäres Herz- und Gefässzentrum, Frankfurt, Germany
University of California, San Francisco, San Francisco, California, United States
Children's Hospital Colorado, Aurora, Colorado, United States
Emory Children's Center, Atlanta, Georgia, United States
the Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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