Patients with severe atopic dermatitis that are not responding to topical therapies such as corticosteroids or immunomodulators are candidates for UV phototherapy or cyclosporin. Some patients fail to respond to these treatments or have to discontinue them due to side-effects (such as hypertension or nephrotoxicity).

Alternative treatments are then needed for these patients. Mycophenolate mophetil has proven to be effective in atopic dermatitis in a few small studies. However gastrointestinal side-effects are common with this drug and some patients have to discontinue it. In a small study published in the British Journal of Dermatology a group of researchers from the Netherlands have used the enteric-coated mycophenolate sodium (720 mg twice daily) in patients with severe adult atopic dermatitis. They found that the patients obtained a mean improvement of 40% in disease activity scores in the 6 month treatment period. In addition, gastrointestinal side-effects were mild and did not lead to dose reductions or discontinuations. No significant changes were found in the laboratory examinations performed during the study. This study shows that enteric-coated mycophenolate sodium can be an effective and well tolerated treatment for patients with atopic dermatitis who fail to respond to other treatments. (more…)

Patients with stage IIB, IIC, or III melanoma have a high risk of relapse and death. Currently treatment with adjuvant systemic interferon alfa-2b is the only treatment approved for patients with stages IIB or III in most western countries. The regimen in use in most centers includes an induction phase with intravenous interferon at doses of 20 million Units per m2/day, 5 days per week for 4 weeks. This is followed by subcutaneous interferon, at a dose of 10 million Units per m2 three times per week for the next 11 months. Although several studies have shown that with high-dose interferon alfa-2b produces an improvement of relapse-free survival, it si not clear that it improves overall survival (the initial study showed a trend for better survival that was not shown in later studies). In addition, high-dose interferon has a high incidence of adverse events that have a negative impact on the patient