Oral mizoribine pulse therapy for patients with steroid-resistant and frequently relapsing steroid-dependent nephrotic syndrome
Oral mizoribine pulse therapy for patients with steroid-resistant and frequently relapsing steroid-dependent nephrotic syndrome
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DOI：
10.1093/ndt/gfh996
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发表时间：
2005-10-01
影响因子：
6.1
通讯作者：
Suzuki, H
中科院分区：
文献类型：
--
作者：
Kawasaki, Y;Hosoya, M;Suzuki, H
背景。研究口服咪唑比滨脉冲治疗环孢素（CyA）依赖性、类固醇耐药性肾病综合征（SRNS）和频繁复发性、类固醇依赖性肾病综合征（FR-SDNS）的疗效。1例cya依赖性SRNS患儿和8例cya依赖性FR-SDNS患儿接受米佐利滨脉冲治疗（日剂量：10mg / kg；最大总剂量500mg）。我们比较了米佐利滨脉冲治疗前后的临床表现，并研究了每名患者服用米佐利滨后数日血清米佐利滨浓度的变化。4例患者无后续复发（应答者）。4名应答者中有2名停用泼尼松龙和CyA，另外2名停用CyA。虽然其他5例患者（无反应）均经历了单次复发，但与咪唑比滨治疗前相比，咪唑比滨治疗后泼尼松龙和CyA的剂量显著减少。有反应者血药浓度峰值高于无反应者（3.6 +/- 0.9 vs 1.8 +/- 0.4 mg/ ml）。米佐利滨-脉冲可能对一些cya依赖性SRNS和FR- SDNS患者有效。
Background. We investigated the efficacy of oral mizoribine pulse therapy ( mizoribine-pulse) for cyclosporin ( CyA)-dependent, steroid-resistant nephrotic syndrome ( SRNS) and frequently relapsing, steroid-dependent nephrotic syndrome ( FR-SDNS).Methods. One child with CyA-dependent SRNS and eight children with CyA-dependent FR-SDNS were treated with mizoribine- pulse ( daily dose: 10 mg/ kg; maximum total dose 500 mg). We compared clinical manifestations before and after mizoribine- pulse, and studied the changes in serum mizoribine concentration in each patient on days when mizoribine was administered.Results. Four patients had no subsequent relapses ( responders). Two of the four responders discontinued prednisolone and CyA, the other two discontinued CyA. Although each of the five other patients ( nonresponders) experienced single subsequent relapses, the dosages of prednisolone and CyA after mizoribine-pulse were decreased significantly compared with before mizoribine- pulse. The peak blood concentration of mizoribine in the responders was higher than in the non-responders ( 3.6 +/- 0.9 vs 1.8 +/- 0.4 mg/ ml).Conclusions. Mizoribine- pulse may be effective for some patients with CyA-dependent SRNS and FR- SDNS.