Mycophenolate Beneficial, Well-tolerated in Recalcitrant, Severe Morphea
Mycophenolate is beneficial in patients with recalcitrant, severe morphea, according to an article published in JAMA Dermatology.
Morphea, a form of scleroderma, is usually treated with a first-line therapy of methotrexate with or without systemic corticosteroids. Mycophenolate (mofetil or mycophenolic acid) is recommend as a second-line therapy.
In this retrospective cohort study, 77 patients with morphea were included, 12 of whom had received mycophenolate alone or in combination as an initial treatment and 65 who received mycophenolate after previous treatment (methotrexate, 74%; systemic corticosteroids, 65%; hydroxychloroquine, 31%; phototherapy, 22%) was ineffective (77%) or poorly tolerated (32%).
After 3 to 6 months of mycophenolate treatment, 66 of 73 patients had stable (n = 22) or improved (n = 44) disease. After 9 to 12 months of treatment, 47 of 54 patients had stable (n = 14) or improved (n = 33) disease.
At study completion, 35% achieved disease remission
Mycophenolate was well tolerated with gastrointestinal adverse effects the most common.
Reference
Arthur M, Fett NM, Latour E, et al. Evaluation of the effectiveness and tolerability of mycophenolate mofetil and mycophenolic acid for the treatment of morphea. JAMA Dermatol. 2020. doi:10.1001/jamadermatol.2020.0035.