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.
Children's Hospital of Alabama, Birmingham, Alabama, United States
C S Mott Children's Hospital, Ann Arbor, Michigan, United States
Children's Hospital of Michigan, Detroit, Michigan, United States
National Institutes of Health Clinical Center, Bethesda, Maryland, United States
UCLA Medical Center: Division of Rheumatology, Los Angeles, California, United States
Yale University School of Medicine: Rheumatology, Allergy & Immunology, New Haven, Connecticut, United States
Emory University School of Medicine: Division of Rheumatology, Atlanta, Georgia, United States
Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
Northwestern University, Chicago, Illinois, United States
Medisch Spectrum Twente, Enschede, Netherlands
Leiden University Medical Center, Leiden, Netherlands
Jeroen Bosch Ziekenhuis, Den Bosch, Netherlands
Fundeni Clinical Institute, Bucharest, Romania
Kasr El Aini Hospital, Cairo, Egypt
The Catholic University of Korea, Seoul, St.Mary's Hospital, Seoul, Korea, Republic of
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