Update on preclinical and clinical experience with mycophenolate mofetil.

As initially predicted by in vitro and animal model experiments, MMF appears to demonstrate significant potential as a new immunosuppressive drug. Early clinical trials have shown that MMF can be used effectively to prevent allograft rejection, and to treat allograft rejection, in heart, liver, and kidney transplant patients. MMF may also help alleviate allograft arteriosclerosis associated with chronic allograft rejection. Three advanced, multicenter, international phase III trials have now shown that MMF at dosages of 2 g/d or 3 g/d improved immunosuppression in renal allografts when compared with either placebo or azathioprine. Our own experience in one of these trials demonstrated that ATGAM induction therapy, followed by a maintenance triple therapy of corticosteroids, cyclosporine, and MMF, is a safe, effective, and well-tolerated regimen for the prophylaxis of acute renal allograft rejection.