RESULTS: A total of 33 patients were treated with MMF for a median of 22.0 months (IQR13.0-104.0). Median age at diagnosis was 51.0 years (IQR 47.0-58.0), 24 (73%) patients were male, and 26 (79%) were Caucasian. Cardiomyopathy with left ventricular ejection fraction (LVEF) <40% was the most common presenting manifestation, affecting 17 (52%) patients, followed by 12 (36%) with atrioventricular block, and 11 (33%) with ventricular arrhythmia; 6 (18%) had more than one of these at presentation. Only 3 (9%) patients had isolated cardiac involvement by sarcoidosis, while 28 (85%) also had pulmonary involvement. All but one patient (97%) initially received concurrent prednisone, 2 (6%) received concurrent anti-tumor necrosis factor-alpha therapy, and 1 (3%) received concurrent cyclosporine. Twenty (of 32, 63%) patients were tapered off prednisone, with median prednisone duration after MMF initiation of 15.0 months (IQR 7.1-33.5). Median time to worsening cardiomyopathy (clinical and/or 10% decrease in LVEF) was 28.0 months, while time to recurrent ventricular arrhythmia was 11.5 months. Six (18%) patients received a VAD, and 5 (15%) underwent transplantation (4 with preceding VAD). After MMF initiation, median time to the composite endpoint of VAD, heart transplant, or death, was 79.0 months. Three (9%) patients not receiving VAD or transplant changed therapy for apparent disease progression. Four (12%) patients stopped MMF due to adverse effects, including cytopenias (3), rash (1), and tremor (1).