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

Kasama, Tsuyoshi; Wakabayashi, Kuninobu; Odai, Tsuyoshi; Isozaki, Takeo; Matsunawa, Mizuho; Yajima, Nobuyuki; Miwa, Yusuke; Negishi, Masao; Ide, Hirotsugu

doi:10.1007/s10165-009-0179-8

Cited by 13 publications

(11 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The clinical efficacy of MZR was first approved in renal transplant recipients (4,5). Since then MZR has been thought to be safe and well tolerated compared with other immunosuppressants, and recent studies havelogical RA treatments in Japan (10,11).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2010

View full text Add to dashboard Cite

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.

show abstract

Section: Introductionmentioning

confidence: 99%

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

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Recent studies have revealed that oral MZR pulse therapy, which is associated with increased serum levels of MZR, may be associated with greater clinical efficacy without significant increase in clinical toxicity when [18][19][20][21]. Additionally, Tsubouchi et al [22] describe a patient with lupus nephritis (WHO class V) who was successfully treated with MZR.…”

Section: Discussionmentioning

confidence: 95%

Mizoribine therapy in a patient with lupus nephritis: the association between mizoribine concentration and peritoneal dialysis

et al. 2010

View full text Add to dashboard Cite

We describe a 20-year-old female with systemic lupus erythematosus (SLE) who developed renal failure during continuous ambulatory peritoneal dialysis (CAPD). The patient was treated with mizoribine (MZR). MZR peak concentration was 1.8 mug/ml and was sufficient for clinical efficacy as measured by serological data. Treatment with MZR was safe and useful even while undergoing CAPD. Achieving optimal MZR blood concentration was important for treatment of SLE, even though the patient was in end-stage renal failure.

show abstract

“…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]. On the other hand, no clinical studies have focused on the effect of a change in the dosing regimen, and the present study was therefore performed to address this issue.…”

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

View full text Add to dashboard Cite

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.

show abstract

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

Cited by 13 publications

References 30 publications

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

Mizoribine therapy in a patient with lupus nephritis: the association between mizoribine concentration and peritoneal dialysis

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

Contact Info

Product

Resources

About