Kevin Phan1,2, Saxon D Smith3,4,5. 1. a Department of Dermatology, Liverpool Hospital , Sydney , Australia. 2. b Faculty of Medicine, University of New South Wales , Sydney , Australia. 3. c Department of Dermatology, Royal North Shore Hospital, St Leonards , Sydney , Australia. 4. d Northern Clinical School, Sydney Medical School, University of Sydney , Sydney , Australia. 5. e The Dermatology and Skin Cancer Centre , Sydney , Australia.
Abstract
Background: For severe cases of atopic dermatitis, systemic or potent agents may be required for control of disease. There have been some reports of treatment efficacy of off-label use of mycophenolate mofetil (MMF) in patients with refractory atopic dermatitis or have developed adverse effects to initial systemic agents. Methods: Electronic searches were performed using six databases from their inception to April 2019. Data were extracted and analyzed according to predefined clinical endpoints. Results: From 140 cases, the mean age was 38.21 ± 22.8 years. There were 52.9% males and 47.1% females. The average number of failed agents was 3.5 ± 1.2. 77.6% reported partial or full remission. Relapses occurred in 8.2% of cases. The average time for initial effects was 6.8 ± 7 weeks. There was a significant reduction in pre to post SCORAD scores by 18 points (p = .0002). More males had complications compared to females. Prolonged duration of treatment ≥1 year was associated with herpes infections. Conclusions: In summary, the current evidence to date is low-quality in nature but is promising regarding the efficacy and safety of MMF for adult and pediatric atopic dermatitis. There should be ongoing monitoring for infections that may develop on long term therapy.
Background: For severe cases of atopic dermatitis, systemic or potent agents may be required for control of disease. There have been some reports of treatment efficacy of off-label use of mycophenolate mofetil (MMF) in patients with refractory atopic dermatitis or have developed adverse effects to initial systemic agents. Methods: Electronic searches were performed using six databases from their inception to April 2019. Data were extracted and analyzed according to predefined clinical endpoints. Results: From 140 cases, the mean age was 38.21 ± 22.8 years. There were 52.9% males and 47.1% females. The average number of failed agents was 3.5 ± 1.2. 77.6% reported partial or full remission. Relapses occurred in 8.2% of cases. The average time for initial effects was 6.8 ± 7 weeks. There was a significant reduction in pre to post SCORAD scores by 18 points (p = .0002). More males had complications compared to females. Prolonged duration of treatment ≥1 year was associated with herpes infections. Conclusions: In summary, the current evidence to date is low-quality in nature but is promising regarding the efficacy and safety of MMF for adult and pediatric atopic dermatitis. There should be ongoing monitoring for infections that may develop on long term therapy.
Authors: Ji Hyun Lee; Jung Eun Kim; Gyeong-Hun Park; Jung Min Bae; Ji Yeon Byun; Min Kyung Shin; Tae Young Han; Seung Phil Hong; Yong Hyun Jang; Hye One Kim; Chan Ho Na; Bark-Lynn Lew; JiYoung Ahn; Chang Ook Park; Young-Joon Seo; Yang Won Lee; Sang Wook Son; Eung Ho Choi; Young Lip Park; Joo Young Roh Journal: Ann Dermatol Date: 2021-11-04 Impact factor: 1.444