Ackermann Amanda L, May Elizabeth R, Frank Linda A
Department of Small Animal Clinical Sciences, University of Tennessee, 2407 River Drive, Knoxville, TN, 37996, USA.
Vet Dermatol. 2017 Apr;28(2):195-e44. doi: 10.1111/vde.12400. Epub 2016 Dec 11.
Mycophenolate mofetil (MMF) is a lymphocytotoxic immunosuppressive agent used in human and companion animal medicine for the treatment of immune-mediated disease. Mycophenolate mofetil is reported to have reduced myelotoxicity and hepatotoxicity when compared to azathioprine.
It was hypothesized that treatment with MMF as a secondary agent with glucocorticoids would be effective in treating immune-mediated skin disease. In addition, adverse effects associated with the drug are reported.
Fourteen dogs from a hospital population diagnosed with immune-mediated skin disease.
A retrospective review of medical records from 2010 to 2015 was used to identify dogs with immune-mediated skin disease that were treated with MMF.
All dogs were treated with MMF (mean dose 14.7 mg/kg twice daily) in conjunction with glucocorticoids. Ten of 14 cases showed positive results, with complete remission in eight cases and partial remission in two cases. Mean time to remission was 5.7 weeks. Therapy was discontinued in one case (perianal fistula) due to lack of response. Adverse events were noted in six cases and included diarrhoea (n = 6), haematochezia (n = 2), vomiting (n = 3) and papilloma formation (n = 1). Therapy was discontinued in two cases with diarrhoea. Mycophenolate mofetil was discontinued in an additional case because of a diagnosis of neoplasia. All other adverse events were self-limiting or easily medically managed. No hepatotoxicity or bone marrow suppression was noted.
This study supports the use of MMF as a second-line immunotherapeutic in immune-mediated skin disease in dogs.
霉酚酸酯（MMF）是一种淋巴细胞毒性免疫抑制剂，用于人类和伴侣动物医学中治疗免疫介导性疾病。据报道，与硫唑嘌呤相比，霉酚酸酯的骨髓毒性和肝毒性有所降低。
假设将MMF作为糖皮质激素的辅助药物进行治疗对免疫介导性皮肤病有效。此外，还报告了与该药物相关的不良反应。
从一家医院确诊患有免疫介导性皮肤病的14只犬。
回顾性分析2010年至2015年的病历，以确定接受MMF治疗的免疫介导性皮肤病犬。
所有犬均接受MMF（平均剂量14.7mg/kg，每日两次）联合糖皮质激素治疗。14例中有10例显示阳性结果，8例完全缓解，2例部分缓解。平均缓解时间为5.7周。1例（肛周瘘管）因无反应而停止治疗。6例出现不良事件，包括腹泻（n = 6）、便血（n = 2）、呕吐（n = 3）和乳头瘤形成（n = 1）。2例腹泻病例停止治疗。另外1例因诊断为肿瘤而停用霉酚酸酯。所有其他不良事件均为自限性或易于药物处理。未观察到肝毒性或骨髓抑制。
本研究支持将MMF用作犬免疫介导性皮肤病的二线免疫治疗药物。
