Occupational and Environmental Lung Diseases |

Mycophenolate Mofetil Is Well Tolerated and May Stabilize Lung Function in Chronic Hypersensitivity Pneumonitis Patients FREE TO VIEW

Lacey Robinson, MD; Yevgeniya Gartshteyn, MD; Niti Agarwal, MD; Lori Shah, MD; Matthew Baldwin, MD; Nina Patel, MD
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Columbia, New York, CO

Chest. 2015;148(4_MeetingAbstracts):766A. doi:10.1378/chest.2260629
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SESSION TITLE: Occupational and Environmental Lung Diseases Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: There are limited data regarding the use of mycophenolate mofetil (MMF) in the treatment of chronic hypersensitivity pneumonitis (HP). We sought to determine whether MMF therapy was well tolerated and associated with stabilized lung function in chronic HP patients.

METHODS: We performed a retrospective case series study of 10 patients with biopsy-proven chronic HP who were treated with MMF at Columbia University Medical Center between 2002 and 2012. We recorded the percent-predicted forced vital capacity (% FVC) and prednisone dose at the start of MMF therapy and after MMF initiation, with a minimum required follow-up period of 3 months. We determined whether subjects experienced a clinically significant decline in lung function, defined as >10% absolute decrease in percent-predicted FVC. Side effects attributed to MMF therapy were abstracted from medical records. The Wilcoxon signed-rank test was used to test the equality of mean percent-predicted FVC and mean prednisone dose at MMF initiation and at follow-up.

RESULTS: Ten patients with chronic HP were treated with MMF during the study period. Two subjects were excluded due to lung transplantation. Eight subjects were analyzed: the mean (SD) age was 59 (5.1) years and 63% were women. Between MMF therapy initiation and follow-up, a median of (IQR) 2.7 (1.6-3.1) years later, there was a statistically but not clinically significant decrease in mean (SD) FVC (59% (15) to 52% (18), p = 0.01), and a decrease in mean (SD) prednisone dose (24 (14) to 9.6 (7.6) mg/day, p = 0.01). None of the 8 subjects discontinued MMF therapy due to bone marrow suppression or hepatotoxicity.

CONCLUSIONS: In a small cohort of chronic HP patients, MMF was well tolerated and was associated with clinical FVC stability over a median follow-up period of 2.7 years. Mean daily prednisone dose decreased significantly during the study period.

CLINICAL IMPLICATIONS: MMF may have a role as a steroid-sparing agent in the treatment of chronic HP.

DISCLOSURE: The following authors have nothing to disclose: Lacey Robinson, Yevgeniya Gartshteyn, Niti Agarwal, Lori Shah, Matthew Baldwin, Nina Patel

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