Oral mizoribine pulse therapy for patients with steroid-resistant and frequently relapsing steroid-dependent nephrotic syndrome

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 chi...

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Veröffentlicht in:Nephrology, dialysis, transplantation dialysis, transplantation, 2005-10, Vol.20 (10), p.2243-2247
Hauptverfasser: Kawasaki, Yukihiko, Hosoya, Mitsuaki, Kobayashi, Schogo, Ohara, Shinichirou, Onishi, Noriko, Takahashi, Ai, Isome, Masato, Suzuki, Hitoshi
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container_end_page 2247
container_issue 10
container_start_page 2243
container_title Nephrology, dialysis, transplantation
container_volume 20
creator Kawasaki, Yukihiko
Hosoya, Mitsuaki
Kobayashi, Schogo
Ohara, Shinichirou
Onishi, Noriko
Takahashi, Ai
Isome, Masato
Suzuki, Hitoshi
description 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 (non-responders) 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 µg/ml). Conclusions. Mizoribine-pulse may be effective for some patients with CyA-dependent SRNS and FR-SDNS.
doi_str_mv 10.1093/ndt/gfh996
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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 (non-responders) 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 µg/ml). Conclusions. Mizoribine-pulse may be effective for some patients with CyA-dependent SRNS and FR-SDNS.</description><identifier>ISSN: 0931-0509</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/gfh996</identifier><identifier>PMID: 16030039</identifier><identifier>CODEN: NDTREA</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Administration, Oral ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anti-Inflammatory Agents - administration &amp; dosage ; Anti-Inflammatory Agents - therapeutic use ; Biological and medical sciences ; Child ; Child, Preschool ; children ; clinical ; Cyclosporine - administration &amp; dosage ; Cyclosporine - therapeutic use ; Drug Resistance ; Emergency and intensive care: renal failure. Dialysis management ; Female ; Glomerulonephritis ; Human viral diseases ; Humans ; Immunosuppressive Agents - administration &amp; dosage ; Immunosuppressive Agents - adverse effects ; Immunosuppressive Agents - blood ; Immunosuppressive Agents - therapeutic use ; Infectious diseases ; Intensive care medicine ; Male ; Medical sciences ; mizoribine oral pulse therapy ; Nephrology. Urinary tract diseases ; Nephropathies. Renovascular diseases. Renal failure ; nephrotic syndrome ; Nephrotic Syndrome - blood ; Nephrotic Syndrome - drug therapy ; Prednisolone - administration &amp; dosage ; Prednisolone - therapeutic use ; Recurrence ; Ribonucleosides - administration &amp; dosage ; Ribonucleosides - adverse effects ; Ribonucleosides - blood ; Ribonucleosides - therapeutic use ; steroid-resistant nephrotic syndrome ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. 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Dial. Transplant</addtitle><description>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 (non-responders) 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 µg/ml). Conclusions. Mizoribine-pulse may be effective for some patients with CyA-dependent SRNS and FR-SDNS.</description><subject>Administration, Oral</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Anti-Inflammatory Agents - administration &amp; dosage</subject><subject>Anti-Inflammatory Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>children</subject><subject>clinical</subject><subject>Cyclosporine - administration &amp; dosage</subject><subject>Cyclosporine - therapeutic use</subject><subject>Drug Resistance</subject><subject>Emergency and intensive care: renal failure. Dialysis management</subject><subject>Female</subject><subject>Glomerulonephritis</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immunosuppressive Agents - administration &amp; dosage</subject><subject>Immunosuppressive Agents - adverse effects</subject><subject>Immunosuppressive Agents - blood</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>Infectious diseases</subject><subject>Intensive care medicine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>mizoribine oral pulse therapy</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Nephropathies. Renovascular diseases. Renal failure</subject><subject>nephrotic syndrome</subject><subject>Nephrotic Syndrome - blood</subject><subject>Nephrotic Syndrome - drug therapy</subject><subject>Prednisolone - administration &amp; dosage</subject><subject>Prednisolone - therapeutic use</subject><subject>Recurrence</subject><subject>Ribonucleosides - administration &amp; dosage</subject><subject>Ribonucleosides - adverse effects</subject><subject>Ribonucleosides - blood</subject><subject>Ribonucleosides - therapeutic use</subject><subject>steroid-resistant nephrotic syndrome</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. 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Dialysis management</topic><topic>Female</topic><topic>Glomerulonephritis</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Immunosuppressive Agents - administration &amp; dosage</topic><topic>Immunosuppressive Agents - adverse effects</topic><topic>Immunosuppressive Agents - blood</topic><topic>Immunosuppressive Agents - therapeutic use</topic><topic>Infectious diseases</topic><topic>Intensive care medicine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>mizoribine oral pulse therapy</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Nephropathies. Renovascular diseases. Renal failure</topic><topic>nephrotic syndrome</topic><topic>Nephrotic Syndrome - blood</topic><topic>Nephrotic Syndrome - drug therapy</topic><topic>Prednisolone - administration &amp; dosage</topic><topic>Prednisolone - therapeutic use</topic><topic>Recurrence</topic><topic>Ribonucleosides - administration &amp; dosage</topic><topic>Ribonucleosides - adverse effects</topic><topic>Ribonucleosides - blood</topic><topic>Ribonucleosides - therapeutic use</topic><topic>steroid-resistant nephrotic syndrome</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kawasaki, Yukihiko</creatorcontrib><creatorcontrib>Hosoya, Mitsuaki</creatorcontrib><creatorcontrib>Kobayashi, Schogo</creatorcontrib><creatorcontrib>Ohara, Shinichirou</creatorcontrib><creatorcontrib>Onishi, Noriko</creatorcontrib><creatorcontrib>Takahashi, Ai</creatorcontrib><creatorcontrib>Isome, Masato</creatorcontrib><creatorcontrib>Suzuki, Hitoshi</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium &amp; Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kawasaki, Yukihiko</au><au>Hosoya, Mitsuaki</au><au>Kobayashi, Schogo</au><au>Ohara, Shinichirou</au><au>Onishi, Noriko</au><au>Takahashi, Ai</au><au>Isome, Masato</au><au>Suzuki, Hitoshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Oral mizoribine pulse therapy for patients with steroid-resistant and frequently relapsing steroid-dependent nephrotic syndrome</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><addtitle>Nephrol. Dial. Transplant</addtitle><date>2005-10-01</date><risdate>2005</risdate><volume>20</volume><issue>10</issue><spage>2243</spage><epage>2247</epage><pages>2243-2247</pages><issn>0931-0509</issn><eissn>1460-2385</eissn><coden>NDTREA</coden><abstract>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 (non-responders) 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 µg/ml). Conclusions. Mizoribine-pulse may be effective for some patients with CyA-dependent SRNS and FR-SDNS.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>16030039</pmid><doi>10.1093/ndt/gfh996</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record>
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source MEDLINE; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection
subjects Administration, Oral
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Anti-Inflammatory Agents - administration & dosage
Anti-Inflammatory Agents - therapeutic use
Biological and medical sciences
Child
Child, Preschool
children
clinical
Cyclosporine - administration & dosage
Cyclosporine - therapeutic use
Drug Resistance
Emergency and intensive care: renal failure. Dialysis management
Female
Glomerulonephritis
Human viral diseases
Humans
Immunosuppressive Agents - administration & dosage
Immunosuppressive Agents - adverse effects
Immunosuppressive Agents - blood
Immunosuppressive Agents - therapeutic use
Infectious diseases
Intensive care medicine
Male
Medical sciences
mizoribine oral pulse therapy
Nephrology. Urinary tract diseases
Nephropathies. Renovascular diseases. Renal failure
nephrotic syndrome
Nephrotic Syndrome - blood
Nephrotic Syndrome - drug therapy
Prednisolone - administration & dosage
Prednisolone - therapeutic use
Recurrence
Ribonucleosides - administration & dosage
Ribonucleosides - adverse effects
Ribonucleosides - blood
Ribonucleosides - therapeutic use
steroid-resistant nephrotic syndrome
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
title Oral mizoribine pulse therapy for patients with steroid-resistant and frequently relapsing steroid-dependent nephrotic syndrome
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