Departments of Dermatology, Royal Melbourne Hospital, Victoria, Australia.
Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Victoria, Australia.
J Dermatolog Treat. 2020 Feb;31(1):46-55. doi: 10.1080/09546634.2019.1572864. Epub 2019 Oct 17.
Mycophenolate mofetil (MMF) is a steroid-sparing immunosuppressant used extensively to treat both common and rare dermatological conditions. Its lymphocyte specificity makes it a favorable therapeutic option particularly for patients who cannot tolerate alternative immunosuppressants. However, the side effect profile of MMF has not been extensively evaluated. This review presents current evidence regarding increased risk of human herpesvirus infection (HHV) with MMF therapy. The electronic database Medline (OVID) was searched on January 2018 for relevant English-language articles regarding the evaluation of incidence/prevalence of HHV infection in patients taking MMF, identifying 24 studies. The majority of available studies were conducted on solid organ transplant recipients receiving complex immunosuppressive treatment including the MMF. Cytomegalovirus is the most well studied of the HHV. A positive association with cytomegaloviruses was found with MMF when compared to alternative immunosuppressants and studies to date suggest dose-dependent effect. MMF is a commonly used steroid-sparing agent used to treat dermatological conditions. This review highlights that MMF is positively associated with cytomegalovirus infection. The presented studies were heterogeneous in study design and detection method, with the majority completed on renal transplant patients. Further studies are needed to shed light on the association of MMF with HHV.
霉酚酸酯(MMF)是一种类固醇免疫抑制剂,广泛用于治疗常见和罕见的皮肤科疾病。其淋巴细胞特异性使其成为一种理想的治疗选择,特别是对不能耐受其他免疫抑制剂的患者。然而,MMF 的副作用尚未得到广泛评估。本综述介绍了目前关于 MMF 治疗与人类疱疹病毒感染(HHV)风险增加的证据。2018 年 1 月,在电子数据库 Medline(OVID)上搜索了关于接受 MMF 治疗的患者中 HHV 感染发生率/流行率评估的相关英文文章,共确定了 24 项研究。大多数可用的研究是在接受包括 MMF 在内的复杂免疫抑制治疗的实体器官移植受者中进行的。巨细胞病毒是研究最多的 HHV。与替代免疫抑制剂相比,MMF 与巨细胞病毒呈正相关,且迄今为止的研究表明存在剂量依赖性效应。MMF 是一种常用的类固醇免疫抑制剂,用于治疗皮肤科疾病。本综述强调了 MMF 与巨细胞病毒感染呈正相关。所提出的研究在研究设计和检测方法上存在异质性,大多数研究是在肾移植患者中完成的。需要进一步的研究来阐明 MMF 与 HHV 的关联。