Mizoribine oral pulse therapy for steroid-dependent nephrotic syndrome.
There have been reports of the use of mizoribine (MZB) oral pulse therapy for the treatment of systemic lupus erythematosus. We report its efficacy in a 9-year-old girl with steroid- and cyclosporine-dependent nephrotic syndrome (NS). The patient experienced relapses of NS when prednisolone was tapered to 20 mg/day after discontinuing cyclosporine due to biopsy proven toxicity. When methylprednisolone pulse therapy combined with prednisolone therapy (40 mg/day) failed to result in a complete remission after 3 weeks, oral MZB pulse therapy (total dose of 500 mg, 10 mg/kg per day in three divided daily doses twice a week) was given. This therapy was continued for 9 months and resulted in complete remission of the NS for 6 months despite the discontinuation of prednisolone. The serum concentration of MZB was above 2.5 microg/ml for about 10 h (from 3 h after the first dose of MZB to 2 h after the final dose). Thus, our results suggest that this regimen may be effective for patients with steroid-dependent NS.
Kawasaki
Yukihiko
Y
Department of Pediatrics, School of Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Fukushima City, Japan. tomo@fmu.ac.jp
Suzuki
Junzo
J
Takahashi
Ai
A
Isome
Masato
M
Nozawa
Ruriko
R
Suzuki
Hitoshi
H
D000284:Administration, Oral; D002648:Child; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D009404:Nephrotic Syndrome / Q000188:drug therapy*; D020551:Pulse Therapy, Drug; D012263:Ribonucleosides / Q000008:administration & dosage*; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D012263:Ribonucleosides; C010052:mizoribine