title: Single daily high-dose mizoribine therapy for children with steroid-dependent nephrotic syndrome prior to cyclosporine administration.
abstract: Although cyclosporine (CsA) therapy is effective in the management of children with steroid-dependent nephrotic syndrome (SDNS), a recent study has revealed that the use of CsA itself was a significant predictor of NS relapse in adulthood. The efficacy of single daily high-dose mizoribine (MZR) therapy was assessed in 10 children with SDNS (mean age, 6.2 years) who had never been treated with CsA previously. MZR was started at 5 mg/kg, administered as a single daily dose after breakfast, and the dose was adjusted to achieve 2-h post-dose MZR levels (C2) of approximately 3 μg/ml. In 9 of the 10 patients, treatment with a single daily dose of MZR (mean dose, 8.4 mg/kg/day) over a period of 22 months (median) resulted in significant reduction of the mean prednisolone dose from 0.39 to 0.15 mg/kg/day and the median 12-month relapse rate from 3.0 to 0.4 episodes/12 months. Although cyclophosphamide was initiated in one patient because of treatment failure, none of the 10 patients required treatment with CsA during the observation period (median, 33 months). These data indicate that single daily high-dose MZR therapy is possibly useful in treating children with SDNS and that it may also eliminate the need for CsA in some patients.
authors.affiliation: Division of Nephrology, Saitama Children's Medical Center, 2100 Magome, Iwatsuki-ward, Saitama-city, Saitama, 339 8551, Japan. f_shuich@d2.dion.ne.jp
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Fujinaga
authors.forename: Daishi
authors.initials: D
authors.lastname: Hirano
authors.forename: Naoto
authors.initials: N
authors.lastname: Nishizaki
authors.forename: Tomonosuke
authors.initials: T
authors.lastname: Someya
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Ohtomo
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Ohtsuka
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Shimizu
authors.forename: Kazunari
authors.initials: K
authors.lastname: Kaneko
mesh_terms: D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D007223:Infant; D007564:Japan; D008297:Male; D009404:Nephrotic Syndrome / Q000188:drug therapy*; D012008:Recurrence; D012263:Ribonucleosides / Q000008:administration & dosage*; D013256:Steroids / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D012263:Ribonucleosides; D013256:Steroids; C010052:mizoribine; D016572:Cyclosporine