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.
James P. Wilmot Cancer Center at University of Rochester Medical Center, Rochester, New York, United States
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, United States
Knight Cancer Institute at Oregon Health and Science University, Portland, Oregon, United States
OHSU Knight Cancer Institute, Portland, Oregon, United States
University of California, San Francisco, San Francisco, California, United States
Children's Hospital, Philadelphia, Philadelphia, Pennsylvania, United States
Children's Hospital, Boston, Boston, Massachusetts, United States
Duke University Medical Center, Durham, North Carolina, United States
UCSD, Thornton Hospital, La Jolla, California, United States
Northwestern University, Chicago, Illinois, United States
DFCI/Brigham & Women's Hospital, Boston, Massachusetts, United States
Fred Hutchinson Cancer Research Center, Seattle, Washington, United States
Washington University/Barnes Jewish Hospital, Saint Louis, Missouri, United States
Mayo Clinic, Rochester, Minnesota, United States
University of Kentucky at Lexington, Lexington, Kentucky, United States
Albert Einstein Medical Center, Philadelphia, Pennsylvania, United States
Texas Transplant Institute, San Antonio, Texas, United States
Columbia University, New York, New York, United States
Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States
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