Efficacy and safety of mycophenolate mofetil in patients with virus-negative lymphocytic myocarditis: A prospective cohort study: Journal of Autoimmunity

G. De Luca, C. Campochiaro, S. Sartorelli, G. Peretto, S. Sala, A. Palmisano, A. Esposito, C. Candela, C. Basso, S. Rizzo, G. Thiene, P. Della Bella, L. Dagna

Research output: Contribution to journalArticlepeer-review


Background: virus-negative lymphocytic myocarditis (VNLM) is a severe inflammatory heart disease with elusive therapies. We aimed to assess the efficacy of mycophenolate-mofetil (MMF) in patients with VNLM. Methods: patients were enrolled in this prospective cohort study and were treated with MMF, as the initial treatment in case of concomitant systemic immune diseases (SIDs), or as rescue therapy in isolated myocarditis intolerant/resistant to azathioprine. All were initially evaluated for endomyocardial biopsy; ECG, 24-h Holter, echocardiography, troponin T and NT-proBNP were obtained in all patients at baseline and after 6 months. The primary end-point was the change in left-ventricular ejection-fraction (LVEF) on echocardiogram after 6 months. Secondary outcomes: decrease in serum NT-proBNP and troponin-T levels, reduction of LV end-diastolic-volume (LVEDV), amelioration of regional wall motion abnormalities (RWMA), and modification of clinical status. Results: 20 patients (10 females, median age at diagnosis 32 [41–59] years) were enrolled. Baseline echocardiography revealed a reduced LVEF (
Original languageEnglish
Article number102330
JournalJ. Autoimmun.
Publication statusPublished - 2020


  • Endomyocardial biopsy
  • Heart failure
  • Mycophenolate mofetil
  • Myocarditis
  • Rescue therapy
  • amino terminal pro brain natriuretic peptide
  • azathioprine
  • beta adrenergic receptor blocking agent
  • dipeptidyl carboxypeptidase inhibitor
  • diuretic agent
  • mycophenolate mofetil
  • prednisone
  • steroid
  • troponin T
  • adult
  • ANCA associated vasculitis
  • Article
  • body weight loss
  • cardiovascular magnetic resonance
  • clinical article
  • cohort analysis
  • dermatomyositis
  • diarrhea
  • diastolic dysfunction
  • drug efficacy
  • drug safety
  • dyspnea
  • echocardiography
  • female
  • heart arrest
  • heart function
  • heart left bundle branch block
  • heart left ventricle ejection fraction
  • heart left ventricle enddiastolic volume
  • heart muscle biopsy
  • heart palpitation
  • heart right bundle branch block
  • heart ventricle tachycardia
  • Holter monitoring
  • human
  • human tissue
  • immunosuppressive treatment
  • leukopenia
  • male
  • middle aged
  • myocarditis
  • New York Heart Association class
  • priority journal
  • prospective study
  • protein blood level
  • side effect
  • systemic lupus erythematosus
  • systemic sclerosis
  • thorax pain
  • two dimensional echocardiography
  • virus genome
  • virus negative lymphocytic myocarditis


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