Is Mycophenolate the Better Immunosuppressive Drug?

Andrew Mackin, BVMS, MVS, DVSC, DACVIM, professor and department head at Mississippi State University College of Veterinary Medicine, says that although mycophenolate and azathioprine are very similar in many ways, there is more evidence that mycophenolate works well for neurological disease.

"Mycophenolate is actually a drug that's been around—at an experimental level—for over 100 years. But in terms of common human usage, it's only been around 20 years, which means that in veterinary medicine has only been around 10. So veterinarians to think tend to think of it as a new drug and new drugs are kind of exciting. If you're burned out on the old drugs you want to reach for the new drugs. And so it's become a drug that's become very popular in the last few years and it's another good, solid immunosuppressive drug.

I actually think of it as very comparable to azathioprine in its mechanisms of action, in the diseases you use it to treat. It's also very inexpensive, so it's another very attractive drug ,and what I actually believe is that the 2 drugs, azathioprine and mycophenolate, are relatively interchangeable. They both are used to much the same diseases and they both have about the same level of efficacy for most of those diseases.

Mycophenolate has the added benefit, I think, of having more evidence that it works well for neurological disease and so I would use it mycophenolate for example for inflammatory brain diseases ahead of using azathioprine. But in many ways these drugs are more similar than different."