Combination Therapy with Methotrexate and Mizoribine for Patients with Rheumatoid Arthritis

Tanaka, Hiroshi; Mine, Takatomo; Tani, Yasuhiro; Chagawa, Kazuki; Taguchi, Toshihiko

doi:10.5035/nishiseisai.57.439

Cited by 4 publications

(2 citation statements)

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“…We demonstrated that treatment with MZR for 24 weeks was completed by 71.9% of patients, of whom 56.3% achieved good or moderate response according to EULAR criteria at 24 weeks. Although patients of old age, with advanced-stage RA or with some complications were included in our study, the clinical efficacy and safety were similar to previous reports that administered a single dose of MZR (19,24,25).…”

Section: Discussionsupporting

confidence: 77%

Efficacy and Safety of Mizoribine by One Single Dose Administration for Patients with Rheumatoid Arthritis

et al. 2010

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Objective Mizoribine (MZR) is an immunosuppressant that inhibits nucleic acid metabolism and is a relatively safe disease-modifying anti-rheumatic drug (DMARD). We evaluated the efficacy and safety of one single dose per day for patients with rheumatoid arthritis (RA). Patients and MethodsIn this study 32 patients with RA received MZR therapy. We evaluated the average dose of MZR and prednisolone, response to treatment and peak plasma level of MZR. Results The average dose of MZR was 146.1±31.2 (range: 50-200) mg/day. The average dose of prednisolone was 4.63±3.59 (range: 0-14) mg/day. The average plasma level of MZR, measured after 3 hours, was 2.20±0.49 μg/mL in the responder group and 1.59±0.82 μg/mL in the non-responder group (p=0.020). The treatment with MZR for 24 weeks was completed by 71.9% of patients and the proportion of patients who achieved a good and moderate response rate according to the European League Against Rheumatism (EU-LAR) criteria was 56.3% at 24 weeks. The plasma level of MZR which was greater than or equal to 2.12 μg/ mL was significantly correlated with the clinical response (p<0.01). Only one of thirty-two cases discontinued the treatment, because of skin eruption. Conclusion This study included patients that could not be treated with other DMARDs and/or biologic agents because of age, interstitial pneumonia and other complications. We show that MZR may be a useful and relatively safe therapy for patients in this group.

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Section: Discussionsupporting

confidence: 77%

Efficacy and Safety of Mizoribine by One Single Dose Administration for Patients with Rheumatoid Arthritis

et al. 2010

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“…One 3-month and one 12-month trial indicated that the single-dose regimen seemed to increase the efficacy of MZR safely [11,12]. Additional pulse administration of MZR with MTX was reported to have some degree of effectiveness for the control of inflammation in patients showing escape or resistance to MTX monotherapy [13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of single-dose mizoribine for patients with rheumatoid arthritis: results at 6 months after switching from a multiple-dose regimen without a change in total daily dose

et al. 2010

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To determine the efficacy and safety of single-dose mizoribine (MZR) for patients with rheumatoid arthritis (RA), a 6-month, single-arm, open-label, prospective observation study was performed. In patients who had been taking MZR at 100-150 mg/day in 2-3 divided portions continuously for at least 3 months, and who had shown a lack of clinical response, or escape (defined as a lack of response at the time of switching, even if some form of response had been shown before that), multiple-dose administration was switched to single-dose administration without changing the total daily dose. Efficacy was assessed in terms of the disease activity score, using the 28-joint count and erythrocyte sedimentation rate (DAS 28-ESR). Of the 34 enrolled patients, 28 met all the eligibility criteria and were assessed for efficacy, and finally 26 patients were able to receive the single-dose regimen throughout the full 6 months. The DAS28-ESR showed a significant decrease from 2 months after switching, and 46.4% of the 28 patients finally achieved a good or moderate response (3 and 10 patients, respectively). With regard to safety, no serious adverse events were observed. In conclusion, the administration of MZR at 100 or 150 mg in a single dose is thought to be a useful alternative form of MZR therapy.

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Effects of low-dose mizoribine pulse therapy in combination with methotrexate in rheumatoid arthritis patients with an insufficient response to methotrexate

et al. 2009

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The aim was to determine the efficacy of low-dose intermittent pulse administration of mizoribine (MZR), a purine synthesis inhibitor, in combination with methotrexate (MTX) to control the symptoms of rheumatoid arthritis (RA) in patients with an insufficient clinical response to MTX alone. Twenty-seven patients with active RA, despite treatment with MTX, were enrolled and given MZR in combination with MTX and continued for 24 weeks. The primary endpoint was assessment of clinical improvements using the European League against Rheumatism (EULAR) criteria. Administering MZR to RA patients with an insufficient response to MTX produced significant improvements in the Disease Activity Score 28 (DAS28) after 8-24 weeks. In addition, after 24 weeks, 60.0% and 8.0% of patients had achieved moderate and good responses, respectively, and there were significant reductions in Modified Health Assessment Questionnaire and serum matrix metalloproteinase-3 levels. The present preliminary study suggests that low-dose MZR in combination with MTX is well tolerated and provides both clinical and economic benefits.

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Combination Therapy with Methotrexate and Mizoribine for Patients with Rheumatoid Arthritis

Cited by 4 publications

References 1 publication

Efficacy and Safety of Mizoribine by One Single Dose Administration for Patients with Rheumatoid Arthritis

Efficacy and Safety of Mizoribine by One Single Dose Administration for Patients with Rheumatoid Arthritis

Efficacy and safety of single-dose mizoribine for patients with rheumatoid arthritis: results at 6 months after switching from a multiple-dose regimen without a change in total daily dose

Effects of low-dose mizoribine pulse therapy in combination with methotrexate in rheumatoid arthritis patients with an insufficient response to methotrexate

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