Mycophenolate mofetil as a systemic antipsoriatic agent: positive experience in 11 patients

Background Mycophenolate mofetil (MMF) is a novel immunosuppressive drug. S everal case reports have suggested that MMF has a beneficial effect in pati ents with psoriasis and autoimmune dermatoses. Objectives To investigate the efficacy and safety of oral MMF in severe pso riasis. Methods Eleven patients with severe stable plaque-type psoriasis and a Psor iasis Area and Severity Index (PASI) between 12 and 53 (mean 30.5) were inc luded in the study. They received oral MMF 1 g twice daily for 3 weeks and then 0.5 g twice daily for 3 weeks. The PASI were determined at baseline (w eek 0) and after 1, 2, 3 and 6 weeks of treatment. Results Within 3 weeks of this therapy there was a reduction in PASI of bet ween 40% and 70% in seven of II patients, and only one patient achieved a r eduction in PASI of <25% from baseline (mean PASI 15.6). Reducing MMF from 2 g daily to 1 g daily led to further, although only slight, improvement in six of 11 patients during the following 3 weeks. In four of 11 patients, t he PASI increased at this lower dosage, and in one patient the drug was wit hdrawn because of muscle pain, which was possibly drug induced. This side-e ffect reversed within a few days after stopping the drug. Other side-effect s, especially gastrointestinal and haematological toxicity, were not observ ed in any of the 11 patients treated. Overall, the mean PASI was 16.1 after 6 weeks. Conclusions We conclude that the immunosuppressant MMF 2 g daily is effecti ve and safe in the treatment of severe psoriasis.