title: Therapeutic effect of mizoribine on pemphigus vulgaris and pemphigus foliaceus.
abstract: We evaluated the effectiveness of mizoribine, a newly developed immunosuppressive agent, as an adjuvant therapy in the treatment of both pemphigus vulgaris and pemphigus foliaceus. Eleven pemphigus patients (eight pemphigus vulgaris and three pemphigus foliaceus) received the combination therapy of prednisolone and mizoribine. Complete remission was observed in three of the eight patients with pemphigus vulgaris and in one of the three patients with pemphigus foliaceus. The four patients with complete remission had a rapid clinical response and achieved remission at a median of 11.8 months. Partial remission was achieved in two of the three patients with pemphigus foliaceus. The median time to achieve partial remission was 16.0 months. Six (55.6%) of the 11 patients with pemphigus had complete or partial remission and were able to taper their prednisolone. The cumulative probability of having a complete remission was 64.3% at 19 months of follow-up using Kaplan-Meier analysis. The effectiveness of the additional mizoribine therapy could be attributed to its corticosteroid-sparing properties as well as its immunosuppressive effects. The serum concentration titer of mizoribine was around 1.0 μg/mL 2 hours after administration. Patients who were not improved by the additional mizoribine might require a continuously higher dose of mizoribine to achieve effective therapy.
authors.affiliation: Department of Dermatology, Kurume University School of Medicine and Kurume University Institute of Cutaneous Cell Biology, Kurume, Japan. hashimot@med.kurume-u.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Tamihiro
authors.initials: T
authors.lastname: Kawakami
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Koga
authors.forename: Bungo
authors.initials: B
authors.lastname: Ohyama
authors.forename: Takahiro
authors.initials: T
authors.lastname: Hamada
authors.forename: Teruki
authors.initials: T
authors.lastname: Dainichi
authors.forename: Takekuni
authors.initials: T
authors.lastname: Nakama
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Yasumoto
authors.forename: Daisuke
authors.initials: D
authors.lastname: Tsuruta
authors.forename: Norito
authors.initials: N
authors.lastname: Ishii
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010392:Pemphigus / Q000188:drug therapy*; D010865:Pilot Projects; D011239:Prednisolone / Q000627:therapeutic use; D012189:Retrospective Studies; D012263:Ribonucleosides / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D012263:Ribonucleosides; C010052:mizoribine; D011239:Prednisolone