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.
Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, United States
Memorial Sloan-Kettering Cancer Center, New York, New York, United States
Policlinico S.Orsola-Malpighi, Bologna, Italy
Addenbrookes Hospital, Cambridge, Cambridgeshire, United Kingdom
University of Mississippi, Jackson, Mississippi, United States
Children's Medical Center of Dallas, Dallas, Texas, United States
New York Medical College, Valhalla, New York, United States
Novartis, Basel, Switzerland
The Johns Hopkins Hospital, Baltimore, Maryland, United States
University of Southern California, Los Angeles, California, United States
Cedars-Sinai Medical Center, Los Angeles, California, United States
Fred Hutch/University of Washington Cancer Consortium, Seattle, Washington, United States
LDS Hospital, Salt Lake City, Utah, United States
Veterans Administration Center-Seattle, Seattle, Washington, United States
Memorial Sloan-Kettering Cancer Center, New York, New York, United States
Masonic Cancer Center at University of Minnesota, Minneapolis, Minnesota, United States
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