Mizoribine for Childhood IgA Nephropathy

Kaneko, Kazunari; Nagaoka, Rieko; Ohtomo, Yoshiyuki; Yamashiro, Yuichiro

doi:10.1159/000045438

Cited by 26 publications

(24 citation statements)

References 7 publications

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“…Subsequently, MZR has been approved in Japan for the treatment of RA (6), SLE (7), nephrotic syndrome (8) and immunoglobulin A (IgA) nephropathy (9). This agent inhibits the proliferation of lymphocytes via inhibition of de novo purine biosynthesis selectively, and therefore it has been thought to inhibit both humoral and cellular immunity (2).…”

Section: Discussionmentioning

confidence: 99%

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: Discussionmentioning

confidence: 99%

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

et al. 2010

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“…Currently, MZR is used for the treatment of renal diseases including IgA nephropathy, nephrotic syndrome, lupus nephritis, and purpura nephritis, and is safe, reliable, and with acceptable efficacy. [8][9][10][11][12][13][14][15][16][17] As MZR increases the transcription activities of glucocorticoid receptors, 5,18 increases the efficacy of glucocorticoids, and reduce, the viral replication induced by long-term use of high-dose glucocorticoids, the present study investigated the efficacy of MZR in combination with moderate dose of glucocorticoids in treating patients with HBV-positive nephrotic syndrome. In the present clinical study, methylprednisolone, MZR, and entecavir were used as the combination treatment.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of mizoribine treatment in nephrotic syndrome complicated with hepatitis B virus infection: a clinical study

Liu

Zhang

et al. 2016

Renal Failure

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Objective The objective of this study is to explore the efficacy and safety of mizoribine (MZR) in treating nephrotic syndrome patients afflicted with hepatitis B virus (HBV). Methods The present study included 36 nephrotic syndrome patients accompanied with HBV infection. A draft of MZR (150-200 mg/d), methylprednisolone (0.6-0.8 mg/kgÁd), and entecavir (0.5 mg/d) was administered to study patients over 24 weeks. The serum albumin (AlB), 24-h urine protein (24-U-TP), liver and renal functions, and HBV-DNA were quantified before and at 2,4,8,12,16,20, and 24 weeks after the treatment. The adverse responses were recorded. Results The AlB levels of patients increased gradually after comprehensive treatment, while the 24-U-TP, serum cholesterol, and triglyceride (TG) levels declined gradually. The changes at 24 weeks post-treatment were statistically significant. Compared with the levels before treatment, the HBV-DNA, transaminase, and renal functions of the patients were not significantly altered after the treatment. No evident adverse response was found. Conclusion Treatment using MZR in combination with methylprednisolone and entecavir in HBV-positive nephrotic syndrome patients displays significant efficacy with a low incidence of adverse reactions. ARTICLE HISTORY

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“…There have been several reports on the treatment of patients having diffuse IgAN with the above-mentioned risk factors in childhood [5, 6, 10, 18, 19,21,22,23]. Welch et al [22] showed no efficacy of prednisone against IgAN in a double-blind, controlled trial of short-term prednisone therapy.…”

Section: Discussionmentioning

confidence: 99%

“…MZB blocks the purine biosynthesis pathway and inhibits mitogen-stimulated T and B cell proliferation. The clinical use of MZB was first approved for renal transplant recipients [17], but in recent years Kaneko et al [18] and Nagaoka et al [19] have shown that MZB is effective against IgAN in childhood.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Multidrug Therapy Combined with Mizoribine in Children with Diffuse IgA Nephropathy in Comparison with Multidrug Therapy without Mizoribine and with Methylprednisolone Pulse Therapy

Kawasaki¹,

Suzuki²,

Onishi³

et al. 2004

Am J Nephrol

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Aim: To evaluate the efficacy of prednisolone, warfarin, and dipyridamole therapy combined with mizoribine (PWDM) in the treatment of diffuse immunoglobulin A (IgA) nephropathy in comparison with prednisolone, warfarin, and dipyridamole therapy without mizoribine (PWD) and with methylprednisolone pulse therapy (PWD pulse). Methods: We collected data on 61 patients diagnosed with diffuse IgA nephropathy, and these patients were retrospectively divided into three groups without randomization. Group A included 21 patients before 1987 who were treated with PWD for 24 months, group B included 20 patients from 1987 to 1989 who were treated with PWD pulse therapy for 24 months, and group C included 20 patients after 1990 who were treated with PWDM for 24 months. Clinical features and pathological findings in each group were analyzed retrospectively. Results: The time from initiation of therapy in group A, group B, and group C was 8.9 ± 5.2, 8.1 ± 3.9, and 7.7 ± 3.8 years, respectively. At the latest follow-up examination, the mean urinary protein excretion (mg/m²/h) was 17 ± 10 in group A, 22 ± 20 in group B, and 6 ± 6 in group C and had decreased significantly in group C as compared with the other groups. The activity index in all three groups was lower at the second biopsy than that at the first biopsy (5.1 ± 0.8 vs. 6.5 ± 2.1 in group A, p < 0.05; 5.6 ± 0.9 vs. 6.6 ± 1.7 in group B, p < 0.01, and 4.5 ± 1.0 vs. 6.8 ± 1.9 in group C, p < 0.01). The chronicity index in groups A and B at second biopsy was higher than at first biopsy (7.3 ± 1.4 vs. 4.8 ± 1.0 in group A, p < 0.01, and 8.1 ± 2.0 vs. 5.3 ± 0.9 in group B, p < 0.01), but was unchanged in group C. At the latest follow-up examination, 1 patient (4.8%) in group A, 3 patients (15%) in group B, and none (0%) in group C had renal insufficiency. Conclusion: These results suggest that PWDM appears to be more effective than PWD or PWD pulse in ameliorating proteinuria and histological severity of patients with IgA nephropathy.

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Mizoribine for Childhood IgA Nephropathy

Cited by 26 publications

References 7 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

Safety and efficacy of mizoribine treatment in nephrotic syndrome complicated with hepatitis B virus infection: a clinical study

Efficacy of Multidrug Therapy Combined with Mizoribine in Children with Diffuse IgA Nephropathy in Comparison with Multidrug Therapy without Mizoribine and with Methylprednisolone Pulse Therapy

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