Mycophenolate mofetil in the treatment of systemic lupus erythematosus

ŞAHİN, Ali

Mycophenolate mofetil in the treatment of systemic lupus erythematosus

Ali ŞAHİN (Ankara Üniversitesi, Tıp Fakültesi, Klinik İmmünoloji ve Romatoloji Ana Bilim Dalı, Ankara, Türkiye)

Eurasian Journal of Medicine

4 0

Yıl: 2009 Cilt: 41 Sayı: 3 Sayfa Aralığı: 180 - 185 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Mycophenolate mofetil in the treatment of systemic lupus erythematosus

Öz:

Mikofenolat mofetil (MMF) transplant hastalarında etkinliği gösterilmiş bir immünsüpresif ajandır. Lupus nefriti ve diğer otoimmün hastalıkların tedavisinde; T ve B lenfositleri hedef alan etki mekanizmasına bağlı olarak, hücresel immün yanıtı ve antikor oluşumunu baskılayarak, etkinliği gösterilmiştir. Myastenia gravis, otoimmün hepatit, immün sitopeniler gibi otoimmün hastalıklarda başarıyla kullanılmaktadır. Fakat, lupus hastalarında böbrek dışı tutulumlarda (hematolojik, nöropsikiyatrik, miyokardiyal, pulmoner, kütanöz vb.) optimal kullanımı kesinlik kazanmamıştır. Bu durumlarda kullanımında optimal doz ve süreye dair yol gösterici randomize kontrollü çalışma henüz bulunmamaktadır. MMF iyi tolere edilmekte ve kullanımı güvenli olmasına rağmen; ürtiker, miyopati, Epstein-Barr virüs ilişkili B-hücreli lenfoma, sitomegalovirüs enfeksiyonları ve dissemine varisella zoster gibi birtakım yan etkiler bildirilmiştir. Ciddi lupus nefritli hastalarda MMF ile immünsüpresif tedavi ve destek bakımı sayesinde son yıllarda klinik sonuçlarda iyileşme sağlanmıştır. İrreversibl renal parankimal hasar oluşmadan önce etkin tedavinin başlanması halinde uzun dönem prognoz daha iyi olabilir. MMF'in uzun süreli kullanımında hastalar için önemli olan bir diğer noktada artan maliyetidir.

Anahtar Kelime:

Konular: Genel ve Dahili Tıp

Sistemik lupus eritematozus tedavisinde mikofenolat mofetil

Öz:

Mycophenolate mofetil (MMF) is an immunosuppressive agent that has been shown to be effective in transplant patients. It is also efficacious in the management of lupus nephritis and useful in the treatment of autoimmune conditions because its mechanisms of action target T- and B- lymphocytes, leading to suppression of the cell-mediated immune response and antibody formation. MMF has been used successfully to treat immune-mediated conditions like myasthenia gravis, autoimmune hepatitis and immune cytopenias. However, the conditions for its optimal use for non-renal manifestations (e.g., hematological, neuropsychiatric, myocardial, pulmonary or cutaneous symptoms) in lupus patients are unclear. There have yet to be any randomized, controlled trials to guide the optimal dose and duration of MMF treatment in such situations. MMF is well tolerated and safe to use, although there are reports of serious adverse effects including urticaria, myopathy, Epstein-Barr virus-associated Bcell lymphoma, cytomegalovirus infection and disseminated varicella zoster infection. Immunosuppressive treatment with MMF and supportive care over the past few decades have led to improved clinical outcomes in patients with severe lupus nephritis. A favorable longterm prognosis can be ensured provided that effective treatment is instituted early, before irreversible renal parenchymal damage occurs. Another area of concern for patients is the increased cost of long-term MMF use.

Anahtar Kelime:

Konular: Genel ve Dahili Tıp

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık

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APA	ŞAHİN A (2009). Mycophenolate mofetil in the treatment of systemic lupus erythematosus. , 180 - 185.
Chicago	ŞAHİN Ali Mycophenolate mofetil in the treatment of systemic lupus erythematosus. (2009): 180 - 185.
MLA	ŞAHİN Ali Mycophenolate mofetil in the treatment of systemic lupus erythematosus. , 2009, ss.180 - 185.
AMA	ŞAHİN A Mycophenolate mofetil in the treatment of systemic lupus erythematosus. . 2009; 180 - 185.
Vancouver	ŞAHİN A Mycophenolate mofetil in the treatment of systemic lupus erythematosus. . 2009; 180 - 185.
IEEE	ŞAHİN A "Mycophenolate mofetil in the treatment of systemic lupus erythematosus." , ss.180 - 185, 2009.
ISNAD	ŞAHİN, Ali. "Mycophenolate mofetil in the treatment of systemic lupus erythematosus". (2009), 180-185.

APA	ŞAHİN A (2009). Mycophenolate mofetil in the treatment of systemic lupus erythematosus. Eurasian Journal of Medicine, 41(3), 180 - 185.
Chicago	ŞAHİN Ali Mycophenolate mofetil in the treatment of systemic lupus erythematosus. Eurasian Journal of Medicine 41, no.3 (2009): 180 - 185.
MLA	ŞAHİN Ali Mycophenolate mofetil in the treatment of systemic lupus erythematosus. Eurasian Journal of Medicine, vol.41, no.3, 2009, ss.180 - 185.
AMA	ŞAHİN A Mycophenolate mofetil in the treatment of systemic lupus erythematosus. Eurasian Journal of Medicine. 2009; 41(3): 180 - 185.
Vancouver	ŞAHİN A Mycophenolate mofetil in the treatment of systemic lupus erythematosus. Eurasian Journal of Medicine. 2009; 41(3): 180 - 185.
IEEE	ŞAHİN A "Mycophenolate mofetil in the treatment of systemic lupus erythematosus." Eurasian Journal of Medicine, 41, ss.180 - 185, 2009.
ISNAD	ŞAHİN, Ali. "Mycophenolate mofetil in the treatment of systemic lupus erythematosus". Eurasian Journal of Medicine 41/3 (2009), 180-185.