title: The beneficial effect of high-dose mizoribine combined with cyclosporine, basiliximab, and corticosteroids on CMV infection in renal transplant recipients.
abstract: BACKGROUND
  Mizoribine (MZR) has been developed as an immunosuppressive agent, but has a less potent immunosuppressive effect up to 3 mg/kg/day MZR. Therefore, we investigated whether high-dose MZR, at 6 mg/kg/day, would be effective and safe for kidney transplant patients in conjunction with cyclosporine (CsA), basiliximab, and corticosteroids.
  
  
  METHODS
  A total of 40 living related patients were administered MZR (6 mg/kg/day), CsA (7 mg/kg/day), prednisolone (maintenance dose 10 mg/day), and basiliximab (20 mg/body). A control group (n = 38) treated with CsA, mycophenolate mofetil (MMF, 25 mg/kg/day), basiliximab, and corticosteroids was also employed in this study.
  
  
  RESULTS
  The 2-year graft survival rates for the MZR and MMF groups were 100 and 94.7 %, respectively. The rejection rate in the MZR group (25 %) was not significantly higher than that in the MMF group (16 %). Serum creatinine level was not significant between the two groups. The number of patients who developed cytomegalovirus (CMV) disease was 0 (0 %) in the MZR group and 7 (18.4 %) in the MMF group (P < 0.05). The number of patients treated with ganciclovir was 3 (7.5 %) and 11 (28.9 %) (P < 0.05), respectively.
  
  
  CONCLUSIONS
  The combination of high-dose MZR with CsA, basiliximab, and corticosteroids can establish not only satisfactory immunosuppression but also a low rate of CMV infection in vivo.
authors.affiliation: Department of Organ Transplantation and General Surgery, Kyoto Prefectural University of Medicine, 465 Hirokoji, Kawaramachi, Kamikyo-ku, Kyoto 602-8566, Japan. nyoshi@koto.kpu-m.ac.jp
authors.forename: Norio
authors.initials: N
authors.lastname: Yoshimura
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Ushigome
authors.forename: Kiyokazu
authors.initials: K
authors.lastname: Akioka
authors.forename: Syuuji
authors.initials: S
authors.lastname: Nobori
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Suzuki
authors.forename: Kazuki
authors.initials: K
authors.lastname: Sakai
authors.forename: Masahiko
authors.initials: M
authors.lastname: Okamoto
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects; D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects; D000998:Antiviral Agents / Q000627:therapeutic use; D000077552:Basiliximab; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000008:administration & dosage* / Q000009:adverse effects; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D004359:Drug Therapy, Combination; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects / Q000276:immunology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage* / Q000009:adverse effects; D012263:Ribonucleosides / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D000998:Antiviral Agents; D015415:Biomarkers; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D012263:Ribonucleosides; C010052:mizoribine; D016572:Cyclosporine; D000077552:Basiliximab; D003404:Creatinine; D015774:Ganciclovir