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

Abstract

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.

Mizoribine as a safe and effective combined maintenance therapy with prednisolone for anti-neutrophil cytoplasmic antibody-associated vasculitis in a hemodialysis patient

“…4). Although these concentrations were lower than the suggested effective dose [20, 21], the PR3-ANCA titer was still reduced sufficiently to maintain remission of the ANCA-associated vasculitis. We do not know the exact reason for MZR’s effectiveness at the lower concentration; however, it was recently reported that 14-3-3 proteins are MZR-binding proteins [24].…”

“…Peak MZR blood levels of >0.66 μg/ml are effective for improving the clinical signs and symptoms of lupus nephritis [20, 21]. On the other hand, liver dysfunction and thrombocytopenia can develop at a trough level of >5 μg/ml [9].…”