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Marcella Grundmann-Kollmann, MD; Maurizio Podda, MD; Falk Ochsendorf, MD; Wolf-Henning Boehncke, MD; Roland Kaufmann, MD; Thomas M. Zollner, MD

Arch Dermatol. 2001;137:870-873.

Objective  To evaluate whether mycophenolate mofetil, a new immunosuppressive 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 mg twice daily until study end (week 8). Patients were followed up for 20 weeks.

Setting  University hospital dermatology department.

Patients  Ten consecutive patients with moderate-severe AD nonresponsive to standard therapy.

Main Outcome Measure  Severity of AD as measured using the subjective SCORAD [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 event, mycophenolate was tolerated well in all patients. Six of 7 patients who had responded to mycophenolate monotherapy had no relapse of disease during 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 of moderate-severe AD.

From the Department of Dermatology, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany.

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