Efficacy of mizoribine followed by low-dose prednisone in patients with idiopathic membranous nephropathy and nephrotic-range proteinuria

Abstract

Efficacy of mizoribine followed by low-dose prednisone in patients with idiopathic membranous nephropathy and nephrotic-range proteinuria, Renal Failure, 35:7,[936][937][938][939][940][941] Background: Idiopathic membranous nephropathy (IMN) patients with persistent high-grade proteinuria are at the highest risk for developing end-stage renal failure. We previously reported the effects of treatment with mizoribine followed by low-dose prednisone treatment in 4 IMN patients. The purpose of the present study was to further assess the effects of this combined treatment in a larger study group. Method: Thirteen patients with IMN and nephroticrange proteinuria received combined treatment. Mizoribine was initiated at a dose of 150 mg/ day, and 2-3 months later, 20 mg/day prednisone was added to the mizoribine regimen. The dosage of prednisone and/or mizoribine was tapered according to the urinary proteinto-creatinine ratio (P/C). We evaluated patient responses for up to 12 months after the initiation of combination therapy. Results: Before treatment, patient urinary P/C ranged from 3.7 to 15.9 g/g. Although these values did not decrease during mizoribine monotherapy, all patients showed dramatic P/C decreases over the course of combination therapy. At 3, 6, and 12 months after combination therapy, 15%, 31%, and 62% of patients attained complete remission, respectively, and all patients were in partial or complete remission 6 months after combination therapy. No notable side effects were observed. Conclusion: The addition of prednisone after mizoribine monotherapy can be beneficial for all IMN patients with nephrotic-range proteinuria syndrome. The risks associated with immunotherapy can be decreased by initially prescribing mizoribine alone, which might act as a base for establishing therapy, followed by low-dose prednisone treatment.

Safety and efficacy of mizoribine treatment in nephrotic syndrome complicated with hepatitis B virus infection: a clinical study

“…Currently, MZR is used for the treatment of renal diseases including IgA nephropathy, nephrotic syndrome, lupus nephritis, and purpura nephritis, and is safe, reliable, and with acceptable efficacy. [8][9][10][11][12][13][14][15][16][17] As MZR increases the transcription activities of glucocorticoid receptors, 5,18 increases the efficacy of glucocorticoids, and reduce, the viral replication induced by long-term use of high-dose glucocorticoids, the present study investigated the efficacy of MZR in combination with moderate dose of glucocorticoids in treating patients with HBV-positive nephrotic syndrome. In the present clinical study, methylprednisolone, MZR, and entecavir were used as the combination treatment.…”