Mycophenolate mofetil is effective in the treatment of atopic dermatitis

Objective: To evaluate whether mycophenolate mofetil, a new immunosuppressi ve agent, is effective for treating moderate-severe atopic dermatitis (AD). Design: In an open-label pilot study, mycophenolate mofetil. 1 g, was given orally twice daily for 4 weeks. At week 5. the dosage was reduced to 500 m g twice daily until study end (week 8). Patients were followed up for 20 we eks. Setting: University hospital dermatology department. Patients: Ten consecutive patients with moderate-severe, AD nonresponsive t o standard therapy. Main Outcome Measure: Severity of AD as measured using the subjective SCORA D [SCORing Atopic Dermatitis] index. Results: Clinical efficacy was measured every 2 weeks using the subjective SCORAD index. Treatment with mycophenolate notably reduced the severity of AD within 4 weeks in all patients (P<.05), and after 8 weeks the mean+/-SD SCORAD index dropped from the pretreatment value of 49.2 +/- 13.8 to 21.9 /- 26.5 (P<.01). One patient had to discontinue mycophenolate therapy after 4 weeks because of the development of herpes retinitis. Except for this ev ent, mycophenolate was tolerated well in all patients. Six of 7 patients wh o had responded to mycophenolate monotherapy had no relapse of disease duri ng 20-week follow-up. In the 7 patients who finished the study, the SCORAD index was reduced by 74%, from 44.0 +/- 7.8 before treatment to 11.4 +/- 5. 9 at 20-week follow-up. Conclusions: Mycophenolate is a highly effective drug for treating moderate -severe AD, with no serious adverse effects occurring in any patients. Thus , mycophenolate might develop into a promising alternative in the therapy o f moderate-severe AD.