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P239. Mycophenolate mofetil in inflammatory bowel disease: The experience of a third level hospital

V. Robles, N. Borruel, A. Torrejón, I. Castells, F. Casellas

Hospital Universitario Valle De Hebrón, Barcelona, Spain

Aim: Mycophenolate mofetil (MFM) is an immunomodulatory drug that inhibits T and B cell proliferation, by reversible inhibition of inositol monophosphate dehydrogenase. Its main use is prevention of organ rejection and its employment in inflammatory bowel disease field is limited due to the lack of prospective and randomized control trials. Our aim is to assess the efficacy of MFM in intolerant or refractory patients to thiopurinic drugs.

Material and Methods: A retrospective overview of the records of all patients treated with this drug for inflammatory bowel disease over a 10 year period at one unique centre (University Hospital Valle de Hebrón, Barcelona, Spain).

Results: We review 31 patients, twenty-one with Crohn's disease diagnosis and ten with ulcerative colitis. The different causes that provoque tiopurinic withdrawal were the following: ten patients suffered from acute pancreatitis, ten patients tiopurinic intolerance, six patients liver toxicity and five patients medular toxicity. The mean duration of the treatment was 32.2 months per patient. We describe a remission rate of 35.4% showing as well endoscopic remission in six of them (54.5%). The side effects rate was 10% (3 patients), in two of them it was necessary to retire the drug.

Conclusion: MFM seems to be a safe alternative to patients with tiopurinic intolerance. Its use outside this setting need further research to be elucidated.