Mizoribine treatment for childhood IgA nephropathy

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

doi:10.1046/j.1328-8067.2001.01532.x

Cited by 20 publications

(18 citation statements)

References 21 publications

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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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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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“…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 was first approved as a drug to prevent rejection of renal transplants in 1984, and the indications were extended to ‘lupus nephritis’ in 1990 and to ‘primary nephritic syndrome’ in 1995 [28]. Nagaoka et al [19] found that MZB could be used as an alternative drug for treatment of moderate childhood IgAN, because it resulted in a significant reduction of proteinuria and hematuria with histological improvement and caused far fewer complications as compared with conventional immunosuppressants.…”

Section: Discussionmentioning

confidence: 99%

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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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“…1(A)] is an effective immunosuppressant isolated from the soil fungus Eupenicillium brefeldianum (Hamasaki et al, 1997;Mizuno et al, 1974;Nagaoka et al, 2002). Its immunosuppressive activity appears to be mediated by the selective inhibition of guanosine monophosphate synthetase and inosine monophosphate dehydrogenase, suppressing nucleic acid synthesis (Koyama and Tsuji, 1983;Kusumi et al, 1989).…”

Section: Introductionmentioning

confidence: 98%

A simple HPLC method for the quantification of mizoribine in human serum: pharmacokinetic applications

Choi¹,

Hur²,

Lee

et al. 2008

Biomedical Chromatography

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A simple high-performance liquid chromatographic (HPLC) method was developed and validated for the quantification of mizoribine in human serum. After the addition of 70% perchloric acid and 3-methylxanthine (50 microg/mL, internal standard) to human serum, the samples were mixed and centrifuged at 12,000 rpm (1432 g) for 10 min. The supernatant was injected onto a C(18) column eluted with a mobile phase of 20 mm Na2HPO4 and methanol (93:7, v/v, pH 3) containing 0.04% octanesulfonic acid and detected utilizing an ultraviolet detector at 275 nm. The linear calibration curve was obtained in the concentration range of 0.1-4.0 microg/mL and the lower limit of quantification was 0.1 microg/mL. This method was validated with selectivity, linearity, precision and accuracy. In addition, the method was successfully applied to estimate the pharmacokinetic parameters of mizoribine in Korean subjects following an oral administration of 100 mg mizoribine (two Bredinine 50 mg tablets). The maximum serum concentration (C(max)) of 2.30 +/- 0.83 microg/mL was reached 2.27 +/- 0.66 h after an oral dose. The mean AUC(0-12 h) and the elimination half-life (t(1/2)) were 13.2 +/- 4.79 microg h/mL and 3.10 +/- 0.74 h, respectively.

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Mizoribine treatment for childhood IgA nephropathy

Abstract: Mizoribine can be an alternative drug for childhood IgAN with moderate severity because it results in a significant reduction of proteinuria and hematuria with histological improvement and causes far fewer complications compared to the conventional immunosuppressants.

Cited by 20 publications

References 21 publications

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

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

A simple HPLC method for the quantification of mizoribine in human serum: pharmacokinetic applications

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