Indications In general, mycophenolate is used for the
prevention of organ transplant rejection. Mycophenolate mofetil is
indicated for the prevention of organ transplant rejection in
adults and renal transplant rejection in children over 2 years;
whereas mycophenolate sodium is indicated for the prevention of
renal transplant rejection in adults. Mycophenolate sodium has also
been used for the prevention of rejection in liver, heart, and/or
lung transplants in children older than two years. An
immunosuppressant that has drastically decreased the incidence of
acute rejection in solid transplant recipients, mycophenolate is
increasingly utilized as a steroid sparing treatment in
immune-mediated disorders including immunoglobulin A nephropathy,
small vessel vasculitides, and psoriasis. Its increasing
application in treating lupus nephritis has demonstrated more
frequent complete response and less frequent complications compared
to cyclophosphamide bolus therapy, a regimen with risk of bone
marrow suppression, infertility, and malignancy. Further work
addressing maintenance therapy demonstrated mycophenolate superior
to cyclophosphamide, again in terms of response and side-effects.
Walsh et al. even propose that mycophenolate should be considered
as a first-line induction therapy for treatment of lupus nephritis
in patients without renal dysfunction,suggesting that mycophenolate
will be encountered more frequently in medical practice.
