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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can MMF Serve As A Substitute For A Minimal Dose Of Prednisone?

Side effects of a 10 mg OD maintenance dose of prednisone for 5 years on a 73-years old female patient suffering from recurring Pemphigus Vulgaris for the last 7 years. Will they be minimal, moderate or heavy. She does not want to take it, being afraid of side effects, and suffers recurrent flares, particularly oral. Can MMF serve as a substitute for this minimal dose of prednisone.
Tue, 31 Jan 2023
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General & Family Physician 's  Response
Hi,

Definitely, MMF and prednisolone both work as immuno-suppressant agents, hence both are being used for treating the most of auto-immune diseases, including Pemphigus vulgaris. Definitely, prednisolone seems to have more side effects than MMF. Still, there are very limited studies available comparing the efficacy and/or side effects of both as well as period of remission between relapses.

However, prednisolone is being used for years in the treatment of auto-immune diseases, with mixed results. Still, there are some studies, which compare the results of MMF + Prednisolone vs Prednisolone alone. These studies have clearly shown a requirement for decreased dose (about 50%) of Prednisolone if being used with MMF. Therefore ,it seems a better option, to use both of the drugs together, thus minimizing the side effects of both drugs individually.

Still, more cost of MMF may be another constraint for using this in place of Prednisolone. The picture may be more clear after some time, when the more extensive studies are available about their effects and side effects, one vs other.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Satnarain Bansal, General & Family Physician
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Can MMF Serve As A Substitute For A Minimal Dose Of Prednisone?

Hi, Definitely, MMF and prednisolone both work as immuno-suppressant agents, hence both are being used for treating the most of auto-immune diseases, including Pemphigus vulgaris. Definitely, prednisolone seems to have more side effects than MMF. Still, there are very limited studies available comparing the efficacy and/or side effects of both as well as period of remission between relapses. However, prednisolone is being used for years in the treatment of auto-immune diseases, with mixed results. Still, there are some studies, which compare the results of MMF + Prednisolone vs Prednisolone alone. These studies have clearly shown a requirement for decreased dose (about 50%) of Prednisolone if being used with MMF. Therefore ,it seems a better option, to use both of the drugs together, thus minimizing the side effects of both drugs individually. Still, more cost of MMF may be another constraint for using this in place of Prednisolone. The picture may be more clear after some time, when the more extensive studies are available about their effects and side effects, one vs other. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Satnarain Bansal, General & Family Physician