Cell cept for Myasthenia Gravis

[Fandangoman]

Does anyone have any experience with taking Cellcept for Myasthenia Gravis ?
I was diagnosed in 2009 and was in what my doctor thinks was a partial remission on Predinisone and Mestinon because my MG antibody count went from 13 to 3 in three years.. My voice is still affected and I am a singersongwriter so my doctor wants me to improve that. After a upper respiratory infection last month I have been having someone more weaknesses and even a slight breathing problem at times, so he wants to put me on Cellcept. The problem is Cellcept can cause Lymphoma and other side effects and infection risk,. I want to get off Prednisone due to weight gain and creeping up hypertension and the Mestinin digestive problems are a real pain. So --

QUESTION: Do you think it is worth the risk if I can possibly manage without it  even thought it means long term Prednisone and Mestinon?

Q: Has anyone had any success with it?
Anyone over 65?

Thanks for your consideration,

[Fandangoman]

     Thank you sir for your response and I will research more and consult my doctors on the Cellcept. I really appreciate your opinion.  Do  you think there is more risk for Cellcept for a  man at 70 YO that say at 50?
     I also have several Herpes antibodies including Zoster, CMV and Epstein Barr (mononucleosis at 15). Would that pose another risk? I believe the` Herpes antobodies are the cause of my Myasthenia There is a model for that pathogenesis. If you lower my resistence to Herpes with Cellcept, the MG could worsen - doesn't that make sense?

Fandangoman, M.S.,Ed.D.

[Dr. Kokil Mathur]

Hi!
I can sort of answer your first question. Mycophenolate mofetil (MMF) or Cellcept  has been extensively researched for its use in myasthenia gravis. Also, it carries a FDA black box warning that it may increase your chances of infection, lymphoma and congenital malformations (for pregnant women). Also, its optimal dose is yet undecided. Pyridostigmine (Mestinon) is the usual first line treatment for MG.  Mycophenolate mofetil should be used with caution in individuals who fail on azathioprine (Mycophenolate mofetil substitute) and corticosteroids. Plasma exchange (PE) and Human immune globulin are tried if there is respiratory problems and gysphagia. Some even benefit with thymectomy or removal of thymus. Tacrolimus is another drug which can be tried. Please discuss your treatment with your treating doctor. Take care!