Real-world use of mycophenolate mofetil in inflammatory bowel disease: Results from the ENEIDA registry

Dig Liver Dis. 2022 May;54(5):635-641. doi: 10.1016/j.dld.2021.10.002. Epub 2021 Nov 30.

Abstract

Background: Studies to evaluate the use of mycophenolate mofetil (MMF) in inflammatory bowel disease (IBD) are limited after the appearance of biological treatments.

Aims: Our primary objective was to evaluate the effectiveness and safety of MMF in IBD.

Methods: IBD patients who had received MMF were retrieved from the ENEIDA registry. Clinical activity as per the Harvey-Bradshaw Index (HBI), partial Mayo score (pMS), physician global assessment (PGA) and C-reactive protein (CRP) were reviewed at baseline, at 3 and 6 months, and at final follow-up. Adverse events and causes of treatment discontinuation were documented.

Results: A total of 83 patients were included (66 Crohn's disease, 17 ulcerative colitis), 90% of whom had previously received other immunosuppressants. In 61% of patients systemic steroids were used at initiation of MMF, and in 27.3% biological agents were co-administered with MMF. Overall clinical effectiveness was observed in 64.7% of the population. At the end of treatment, 45.6% and 19.1% of subjects showed remission and clinical response, respectively. MMF treatment was maintained for a median of 28.9 months (IQR: 20.4-37.5).

Conclusion: Our study suggests, in the largest cohort to date, that MMF may be an effective alternative to thiopurines and methotrexate in IBD.

Keywords: Crohn's disease; Inflammatory bowel disease; Mycophenolate mofetil; Ulcerative colitis.

MeSH terms

  • Chronic Disease
  • Colitis, Ulcerative* / drug therapy
  • Crohn Disease* / drug therapy
  • Humans
  • Inflammatory Bowel Diseases* / drug therapy
  • Mycophenolic Acid / therapeutic use
  • Registries

Substances

  • Mycophenolic Acid