Management of Cardiac Sarcoidosis Using Mycophenolate Mofetil as a Steroid-Sparing Agent.
J Card Fail
; 27(12): 1348-1358, 2021 12.
Article
in En
| MEDLINE
| ID: mdl-34166800
ABSTRACT
BACKGROUND:
Cardiac sarcoidosis (CS) is a major cause of morbidity and mortality in patients with systemic sarcoidosis. Steroid-sparing agents are increasingly used, despite a lack of randomized trials or published guidelines to direct treatment. METHODS ANDRESULTS:
This retrospective study included 77 patients with CS treated with prednisone monotherapy (nâ¯=â¯32) or a combination with mycophenolate mofetil (nâ¯=â¯45) between 2003 and 2018. Baseline characteristics and clinical outcomes were evaluated. The mean patient age was 53 ± 11 years at CS diagnosis, 66.2% were male, and 35.1% were Black. The total exposure to maximum prednisone dose (initial prednisone doseâ¯×â¯days at dose) was lower in the combination therapy group (1440 mg [interquartile range (IQR), 1200-2760 mg] vs 2710 mg [IQR, 1200-5080 mg]; Pâ¯=â¯.06). On 18F-fluorodeoxyglucose positron emission tomography scans, both groups demonstrated a significant decrease in the cardiac maximum standardized uptake value after treatment a median decrease of 3.9 (IQR 2.7-9.0, Pâ¯=â¯.002) and 2.9 (IQR 0-5.0, Pâ¯=â¯.001) for prednisone monotherapy and combination therapy, respectively. Most patients experienced improvement or complete resolution in qualitative cardiac 18F-fluorodeoxyglucose uptake (92.3% and 70.4% for the prednisone and combination therapy groups, respectively). Mycophenolate mofetil was well tolerated.CONCLUSIONS:
Mycophenolate mofetil in combination with prednisone for the treatment of CS may minimize corticosteroid exposure and decrease cardiac inflammation without significant adverse effects.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Sarcoidosis
/
Heart Failure
Type of study:
Guideline
/
Observational_studies
/
Qualitative_research
Limits:
Adult
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Card Fail
Journal subject:
CARDIOLOGIA
Year:
2021
Document type:
Article