title: Long-term open-trial of mizoribine with prednisolone in 24 patients with multiple sclerosis: safety, clinical and magnetic resonance imaging outcome.
abstract: OBJECTIVE
  Mizoribine (MZR), imidazole nucleotide, inhibits purine synthesis and helper T cell functions. It is used as an immunosuppressant in chronic rheumatic arthritis in Japan. Twenty-four patients with relapsing-remitting and chronic progressive multiple sclerosis (MS) were studied for the long-term effects of MZR over 8 years.
  
  
  METHODS
  Average daily MZR doses of 200 mg along with prednisolone (PSL) were administered in the patients studied. Ten of 24 patients were treated for more than 5 years.
  
  
  RESULTS
  The mean relapse rate per year at entry (1.50 +/- 0.24, mean +/- SE, n = 22) decreased [0.46 +/- 0.24 (n = 19)] after two years. In 70% of the patients, the disability did not worsen. Eleven of 18 patients showed a mild decrease of the total lesion size in magnetic resonance imaging (MRI).
  
  
  CONCLUSIONS
  MZR was well tolerated and could be used for long-term in MS as an adjunctive immunosuppressant to PSL, and the PSL doses could be decreased. A further randomized controlled trial with PSL is necessary.
authors.affiliation: Department of Neurology, Nishinara National Hospital, Nara.
authors.forename: K
authors.initials: K
authors.lastname: Saida
authors.forename: Z
authors.initials: Z
authors.lastname: Zhigang
authors.forename: K
authors.initials: K
authors.lastname: Ozawa
authors.forename: T
authors.initials: T
authors.lastname: Konishi
authors.forename: T
authors.initials: T
authors.lastname: Saida
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy*; D011239:Prednisolone / Q000009:adverse effects / Q000627:therapeutic use; D012008:Recurrence; D012263:Ribonucleosides / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D012263:Ribonucleosides; C010052:mizoribine; D011239:Prednisolone