Smartest Doc
Efficacy of weekly mizoribine pulse therapy in refractory lupus nephritis
Modern Rheumatology, 05/08/2012
Clinical Article
Nishi E et al. – Intermittent administration of mizoribine can increase blood levels and may be effective for refractory lupus nephritis.
Methods- Seventeen patients with lupus nephritis who had been resistant to corticosteroid and immunosuppressant therapy received weekly mizoribine pulse therapy.
- Mizoribine (350 mg) was administered three times at 12 h intervals over 2 consecutive days (700 mg for day 1 and 350 mg for day 2), followed by a washout period from day 3 to day 7.
- This therapeutic strategy enabled the peak blood levels of mizoribine to be increased to more than 3 μg/mL in most of the patients.
- Although SLEDAI, anti–ds–DNA antibody titer, CH–50, and serum albumin level did not significantly improve, urinary protein levels decreased, and it was possible to taper the dose of concomitant steroids.
- Using the definition of clinical response, 10 of the 17 patients were responders and 4 of them were nonresponders.
- The average peak serum mizoribine concentration of the responders was as high as 3.5 μg/mL.
- Elevation of serum liver enzymes was seen in 1 patient, and hyperuricemia occurred in 4 cases, but none of these adverse events were serious.