Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York 10016, USA.
J Am Acad Dermatol. 2012 May;66(5):767-70. doi: 10.1016/j.jaad.2011.06.004. Epub 2011 Jul 23.
There is a paucity of investigation on which to base the treatment of chronic urticaria after a patient fails maximum therapy with antihistamines. One prospective, open-label, uncontrolled study suggested that mycophenolate mofetil may be a successful second-line therapy.
We sought to evaluate the efficacy and safety of mycophenolate mofetil in 19 patients with autoimmune and chronic idiopathic urticaria.
In a retrospective chart review, records of patients with autoimmune and chronic idiopathic urticaria who were evaluated between 2001 and 2009 were analyzed.
Improvement in urticaria was observed in 89% of patients, specifically 91% of patients with autoimmune urticaria and 88% with chronic idiopathic urticaria. Time to initial improvement ranged from 1 to 9 weeks. In 59% of these patients, complete control of urticaria was achieved, which included 70% of patients with autoimmune urticaria and 43% with chronic idiopathic urticaria. Mean time to complete control was 14 weeks, with a range of less than 1 to 31 weeks. The dose of mycophenolate mofetil at complete control ranged from 1000 to 6000 mg divided twice daily. Mycophenolate mofetil was tapered in 7 of these 10 patients after an average of 7 weeks. Six of the 7 patients tapered then discontinued mycophenolate mofetil with remissions lasting between 2 and 16 weeks up to when the chart review ended. Mycophenolate mofetil was well tolerated with no serious infections or laboratory abnormalities. Gastrointestinal symptoms were most common.
This was a retrospective chart analysis. The number of patients was relatively small.
Mycophenolate mofetil is a useful and well-tolerated second-line therapy for patients with autoimmune and chronic idiopathic urticaria in whom antihistamines and other therapeutic agents have failed.
在抗组胺药最大治疗后，慢性荨麻疹患者的治疗依据不足。一项前瞻性、开放标签、非对照研究表明，霉酚酸酯可能是一种成功的二线治疗药物。
我们旨在评估霉酚酸酯治疗自身免疫性和慢性特发性荨麻疹 19 例患者的疗效和安全性。
在回顾性病历分析中，分析了 2001 年至 2009 年间评估的自身免疫性和慢性特发性荨麻疹患者的病历记录。
89%的患者荨麻疹得到改善，具体来说，自身免疫性荨麻疹患者为 91%，慢性特发性荨麻疹患者为 88%。初始改善时间为 1 至 9 周。在这些患者中，59%的患者完全控制了荨麻疹，其中自身免疫性荨麻疹患者为 70%，慢性特发性荨麻疹患者为 43%。完全控制的平均时间为 14 周，范围为不到 1 周至 31 周。完全控制时霉酚酸酯的剂量为每天两次，1000 至 6000mg 不等。在平均 7 周后，这 10 名患者中有 7 名逐渐减少霉酚酸酯的剂量。这 7 名患者中有 6 名在逐渐减少剂量并停止使用霉酚酸酯后，缓解期持续 2 至 16 周，直至病历审查结束。霉酚酸酯耐受性良好，无严重感染或实验室异常。胃肠道症状最常见。
这是一项回顾性病历分析。患者数量相对较少。
霉酚酸酯是抗组胺药和其他治疗药物治疗失败的自身免疫性和慢性特发性荨麻疹患者的一种有用且耐受良好的二线治疗药物。
