Enteric-coated mycophenolate sodium in the treatment of non-infectious intermediate uveitis: results of a prospective, controlled, randomised, open-label, early terminated multicentre trial.

Christoph M E Deuter, Katrin Engelmann, Arnd Heiligenhaus, Ines Lanzl, Friederike Mackensen, Thomas Ness, Uwe Pleyer, Nicole Stuebiger, Barbara Wilhelm, Holger Luedtke, Manfred Zierhut, Deshka Doycheva

Journal: The British journal of ophthalmology 2019;102(5):647-653

PMID: 28903965

Abstract

BACKGROUND/AIMS

To evaluate the efficacy, safety and tolerability of enteric-coated mycophenolate sodium (EC-MPS) in combination with low-dose corticosteroids compared with a monotherapy with low-dose corticosteroids in subjects with non-infectious intermediate uveitis (IU).

METHODS

Open-label, prospective, controlled, randomised multicentre trial. Patients were randomised in a 1:1 ratio to either the treatment group (prednisolone plus EC-MPS) or control group (prednisolone monotherapy). Patients in the control group who relapsed within 6 months changed to the crossover group (prednisolone plus EC-MPS). Maximum treatment duration was 15 months. The primary endpoint was the time to first relapse in the treatment group and control group.

RESULTS

Forty-one patients at eight sites were analysed. Twenty-two patients were allocated to the treatment group, with 19 patients in the control group. A first relapse occurred in 9 patients (40.9%) in the treatment group and 15 patients (78.9%) in the control group (p=0.03). The median time to the first relapse was >15 months for the treatment group and 2.8 months for the control group (p=0.07). The probability of relapse-free survival at month 15 was estimated to be 52.9% in the treatment group and 19.7% in the control group (p=0.01). 15 patients changed to the crossover group. Of these, only four patients developed a second relapse. No safety concerns arose during the trial. Only one patient had to discontinue EC-MPS due to increased liver enzymes.

CONCLUSION

EC-MPS can be considered an effective and well-tolerated immunosuppressive drug to prevent relapses in patients with chronic IU.

TRIAL REGISTRATION NUMBER

EUDRACT number: 2009-009998-10, Results.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Address: Centre for Ophthalmology, University of Tuebingen, Tuebingen, Germany.; Eye Clinic, Klinikum Chemnitz gGmbH, Chemnitz, Germany.; Department of Ophthalmology, St. Franziskus Hospital, Muenster, Germany.; Department of Ophthalmology, Technical University of Munich, Munich, Germany.; Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg, Germany.; University Eye Center, University of Freiburg, Freiburg, Germany.; Department of Ophthalmology, Campus Virchow-Klinikum, Charite University Medicine, Berlin, Germany.; Department of Ophthalmology, Campus Benjamin Franklin, Charite University Medicine, Berlin, Germany.; STZ eyetrial at the Centre for Ophthalmology, University of Tuebingen, Tuebingen, Germany.; DatInf GmbH, Tuebingen, Germany.

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