About Lupus, Featured, Main Blog, Medications

Lupus and CellCept®

WHAT IS IT?

CellCept® or mycophenolate mofetil, is a medication that was first prescribed to treat people who have had an organ transplant.  Over the last 15 years, it has been increasingly used more to treat immune disorders, like systemic lupus erythematosus, lupus nephritis, rheumatoid arthritis, scleroderma and other lupus overlap diseases.   

This blog is intended to provide both clarity and insight for those who are newly diagnosed, or those who, for the first time, are being prescribed CellCept®.  

WHERE DID IT COME FROM?

Cellcept® was first approved by the US Food and Drug Administration in 1995 for use in kidney transplantation.  Originally discovered in 1893 by Italian scientist Bartolomeo Gosio, mycophenolic acid was first used as an antibiotic, later being used for its antiviral, antifungal, antibacterial, anticancer and anti-psoriasis properties. South African geneticist Anthony Allison and his wife, Elsie M. Eugui developed the first clinically usable version of the drug in the 1970’s after successful trials demonstrated that it was useful in organ transplantation and immunosuppressive activity.  

HOW DOES IT WORK?

CellCept® is an immunosuppressant medication.  With lupus, the immune system mistakes the tissue in the body as foreign and attacks it.  Immunosuppressants are prescribed to suppress the immune response by interfering with DNA synthesis, which stops the attack cells of the immune system from dividing, by inhibiting the growth of T cells and B cells (subtypes of white blood cells).  

Usually prescribed to control moderate to severe lupus with kidney, lung, brain and cardiovascular involvement, CellCept® works in conjunction with other lupus medications.  In fact, it is often called a “steroid-sparing” or “adjuvant” drug – meaning it is given in substitute or instead of steroid therapy. CellCept® is beneficial because it may reduce or eliminate the need of steroids (and their harsh side effects) while improving lupus symptoms.  

HOW IS IT TAKEN?

In adults, CellCept® is usually taken two times daily, for a total dose of 2000-3000 milligrams.  Children typically take less than two grams per day.  It helps to take it with food, to prevent stomach upset.  It is important to check blood levels regularly, because it can affect the liver and other blood counts.     

BENEFITS

Cellcept® has shown clinical evidence of controlling lupus symptoms, preventing organ damage, and improving overall prognosis for lupus or other organ involvement in systemic lupus erythematosus.  A recent clinical study showed that CellCept® was even more beneficial than Imuran® (azathioprine).  Another study by the National Institute of Health stated it’s effectiveness in the management of specifically lupus nephritis, as well as a wide array of autoimmune conditions because of it’s T cell and B cell suppression and immune response.  This is all good news for those who cannot tolerate other medications, who are not good candidates for Benlysta, or those who are trying to taper off of steroids.  

SIDE EFFECTS

Immunosuppressive medications like CellCept® are strong and should only be used under the watchful care of a physician.  Because CellCept® suppresses the immune system, those on it are at a greater risk for developing infections.  To protect yourself, stay away from large crowds, people who have colds or other illnesses, and wash your hands regularly.  Additionally, CellCept® and other immunosuppressant medications may increase the risk of malignancy development later in life if used for a prolonged amount of time.  If you are pregnant or are planning to become pregnant, or are nursing, talk to your doctor before starting CellCept®. Pregnant women who are taking CellCept® have a higher probability of miscarriage within the first three months of pregnancy, as well as, an increase in birth defects.   

The most common side effects include:

  • Stomach pain
  • Headache
  • Diarrhea
  • Vomiting
  • High blood pressure
  • Swelling in the lower legs
  • Constipation
  • Weakness

IMPORTANT INFORMATION

Sadly, even though recent studies have found CellCept® more beneficial than other immunosuppressants, it is more costly and restricted by some insurance carriers.   

It is important to talk to your doctor about all your concerns about this medication, including the cost, potential side effects, and any drug interactions.  

At Molly’s Fund Fighting Lupus, we understand that treatments are not a “one size fits all.”  Every lupus patient is unique, and requires a treatment plan to fit that uniqueness.   We hope understanding CellCept® will help you to have an open and honest conversation with your doctor about whether this is the right treatment for you.  

Sources:

http://www.cellcept.com/patient/cellcept-anti-organ-rejection-medication

http://ard.bmj.com/content/76/9/1575?etoc&utm_content=buffer8b46e&utm_medium=social&utm_source=facebook.com&utm_campaign=buffer

http://abcnews.go.com/Health/Living/story?id=116660

https://en.wikipedia.org/wiki/Mycophenolic_acid

https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Treatments/Mycophenolate-Mofetil-Mycophenolate-Sodium

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4261281/

https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Treatments/Mycophenolate-Mofetil-Mycophenolate-Sodium

*All images unless otherwise noted are property of and were created by Molly’s Fund Fighting Lupus. To use one of these images, please contact us at [email protected] for written permission; image credit and link-back must be given to Molly’s Fund Fighting Lupus. **All resources provided by Molly’s Fund are for informational purposes only and should be used as a guide or for supplemental information, not to replace the advice of a medical professional. The personal views do not necessarily encompass the views of the organization, but the information has been vetted as a relevant resource. We encourage you to be your strongest advocate and always contact your medical provider with any specific questions or concerns.

Article by : Kelli Roseta

Kelli Roseta is the Client Services Coordinator for Molly’s Fund Fighting Lupus and facilitates the patient and caregiver support groups. She is also a 25-year lupus survivor. Connect with Kelli at [email protected].