Abstract
We describe a 20-year-old female with systemic lupus erythematosus (SLE) who developed renal failure during continuous ambulatory peritoneal dialysis (CAPD). The patient was treated with mizoribine (MZR). MZR peak concentration was 1.8 μg/ml and was sufficient for clinical efficacy as measured by serological data. Treatment with MZR was safe and useful even while undergoing CAPD. Achieving optimal MZR blood concentration was important for treatment of SLE, even though the patient was in end-stage renal failure.
Similar content being viewed by others
References
Mizuno K, Tsujino M, Takada M, Hayashi M, Atsumi K, Matsuda T. Studies on Bredinin. I. Isolation, characterization and biological properties. J Antibiot (Tokyo). 1974;27:775–84.
Ishikawa H. Mizolobine and mycophenolate Mofetil. Curr Med Chem. 1999;6:575–97.
Gerber DA, Bonham CA, Thomson AW. Immunosuppressive agents: recent development in molecular action and chemical application. Transplant Proc. 1998;1:89–90.
Suthanthiran M, Morris RE, Strom TB. Immunosuppressants: cellular and molecular mechanisms of action. Am J Kidney Dis. 1996;28:159–72.
Hughes SE, Gruber SA. New immunosuppressive drugs in organ transplantation. J Clin Pharmacol. 1996;36:1081–92.
Kokado Y, Ishibashi I, Jiang H. Low dose cyclosporine, mizoribine and prednisolone in renal transplantation: a new triple therapy. Clin Transplant. 1990;4:191–7.
Inoue T, Kusaba R, Takahashi I, Sugumoto H, Kuzuhara K, Yamada Y, et al. Clinical trial of Bredinine in renal transplantation. Transplant Proc. 1981;13:315–8.
Shiokawa Y, Akizuki R, Yokohari R, Hashimoto H, Kashiwazaki S, Kondo H, et al. Clinical evaluation of mizoribine on rheumatoid arthritis: a double-blind comparative study using lobenzariddisodium as a standard drug (in Japanese). Igakunoayumi. 1991;156:811–31.
Yoshioka K, Ohashi Y, Sakai T, Ito H, Yoshikawa N, Nakamura H, et al. A multicenter trial of mizoribine compared with placebo in children with frequency relapsing nephritic syndrome. Kidney Int. 2000;58:317–24.
Kaneko K, Nagaoka R, Ohtomo Y, Yamashiro Y. Mizoribine for childhood IgA nephropathy. Nephron. 1999;83:376–7.
Aihara Y, Miyamae T, Ito S, Kobayashi S, Imagawa T, Mori M, et al. Mizoribine as an effective combined maintenance therapy with prednisolone in childhood-onset systemic lupus erythematosus. Pediatr Int. 1999;19:2–11.
Tanaka H, Suzuki K, Nakahata T, Tsugawa K, Ito E, Wada S. Mizoribine oral pulse therapy for patients with disease flare of lupus nephritis. Clin Nephrol. 2003;60:390–4.
Fukunishi T, Takahashi S, Hashinaka Y, Oota K, Nagano S, Takada K, et al. Bredinine concentration in blood and immunosuppressive effect (in Japanese). Ishyoku Jpn J Transplant. 1982;17(Suppl):750–2.
Sonda K, Takahashi K, Tanabe K, Funchinose S, Hayasaka Y, Kawaguchi H, et al. Clinical pharmacokinetic study of mizoribine in renal transplantation patients. Transplant Proc. 1996;28:3643–8.
Kuroda T, Hirose S, Tanabe N, Sato H, Nakatsue T, et al. Mizoribine therapy for patients with lupus nephritis: the association for peak mizoribine concentration and clinical efficacy. Mod Rheumatol. 2007;17:206–12.
Shetty H, Gokal R. Peritoneal dialysis as the first-choice treatment. Ronco C, Dell’Aquila R, Rodighiero MP, editors. Peritoneal dialysis today. Contrib Nephrol. vol 140. Basel: Karger; 2003. p. 218–225.
Japanese Society of Dialysis Therapy. An overview of regular dialysis treatment in Japan as of Dec. 31, 2008. 2009:1–22 (in Japanese).
Tanaka H, Oki E, Tsuruga K, Sato N, Matsukura H, Matsunaga A, et al. Mizoribine treatment of young patients with severe lupus nephritis: a clinicopathologic study by the Tohoku pediatric study group. Nephron Clin Pract. 2008;110:c73–9.
Kasama T, Wakabayashi K, Odai T, Isozaki T, Matsunawa M, Yajima N, et al. Effects of low-dose mizoribine pulse therapy in combination with methotrexate in rheumatoid arthritis patients with an insufficient response to methotrexate. Mod Rheumatol. 2009;19(4):395–400.
Doi T, Masaki T, Shiraki N, Kawai T, Yorioka N. Oral mizoribine pulse therapy for steroid-dependent focal segmental glomerulosclerosis. Clin Nephrol. 2008;69:433–5.
Ikezumi Y, Suzuki T, Karasawa T, Kawachi H, Nikolic-Paterson DJ, Uchiyama M. Use of mizoribine as a rescue drug for steroid-resistant pediatric IgA nephropathy. Pediatr Nephrol. 2008;23:645–50.
Tsubouchi Y, Fukuda W, Kawahito K, Kohno M, Wada M, Ishino H, et al. A case of lupus nephritis improved after appropriately adjusting the dosage of mizoribine. Mod Rheumatol. 2008;18:91–5.
Acknowledgments
The authors would like to thank Asahi-Kasei Pharm, Tokyo, for the measurements and analysis of the blood levels of MZR.
Conflict of interest statement
None.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Kuroda, T., Kobayashi, D., Sato, H. et al. Mizoribine therapy in a patient with lupus nephritis: the association between mizoribine concentration and peritoneal dialysis. Mod Rheumatol 20, 296–300 (2010). https://doi.org/10.1007/s10165-009-0267-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10165-009-0267-9