Mizoribine therapy combined with steroids and mizoribine blood concentration monitoring for idiopathic membranous nephropathy with steroid-resistant nephrotic syndrome
| Autor: | Satoru Ogahara, Koichi Matsumoto, Akio Koyama, Enyu Imai, Hiroshi Sato, Tetsuya Mitarai, Yasuhiko Tomino, Yoshie Sasatomi, Shiro Ueda, Shoichi Maruyama, Hitoshi Yokoyama, Masayuki Iwano, Noriaki Yorioka, Masaomi Nangaku, Seiichi Matsuo, Takao Saito, Ashio Yoshimura, Yasufumi Kataoka, Shinichi Nishi |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Nephrology medicine.medical_specialty Nephrotic Syndrome Physiology Prednisolone 030232 urology & nephrology Urology 030204 cardiovascular system & hematology Glomerulonephritis Membranous law.invention 03 medical and health sciences 0302 clinical medicine Blood concentration Randomized controlled trial law Physiology (medical) Internal medicine medicine Humans Prospective Studies Glucocorticoids Aged Steroid-resistant nephrotic syndrome Idiopathic membranous nephropathy Mizoribine business.industry Middle Aged medicine.disease Idiopathic Membranous Nephropathy Once-a-day administration Estimated serum concentration curve Endocrinology Original Article Female Ribonucleosides business Nephrotic syndrome Immunosuppressive Agents medicine.drug |
| Zdroj: | Clinical and Experimental Nephrology |
| ISSN: | 1342-1751 |
| Popis: | Background We designed a prospective and randomized trial of mizoribine (MZR) therapy combined with prednisolone (PSL) for idiopathic membranous nephropathy (IMN) with steroid-resistant nephrotic syndrome (SRNS). Methods Patients with IMN were divided into 2 groups, and MZR combined with PSL was administered for 2 years. PSL was initially prescribed at 40 mg/day and tapered. MZR was given once-a-day at 150 mg and 3-times-a-day at 50 mg each to groups 1 and 2. Serum MZR concentrations from 0 to 4 h after administration were examined within one month of treatment. The concentration curve and peak serum level (C max) of MZR were estimated by the population pharmacokinetic (PPK) parameters of MZR. Results At 2 years, 10 of 19 patients (52.6 %) in group 1 and 7 of 18 patients (38.9 %) in group 2 achieved complete remission (CR). The time-to-remission curve using the Kaplan–Meier technique revealed an increase in the cumulative CR rate in group 1, but no significant difference between the groups. Meanwhile, there was a significant difference in C max between groups 1 and 2 (mean ± SD: 1.20 ± 0.52 vs. 0.76 ± 0.39 μg/mL, p = 0.04), and C max levels in CR cases were significantly higher than those in non-CR cases. Receiver operating characteristic analysis showed that C max more than 1.1 µg/mL was necessary for CR in once-a-day administration. Conclusion Administration of MZR once a day is useful when combined with PSL for treatment of IMN with SRNS. In addition, it is important to assay the serum concentration of MZR and to determine C max, and more than 1.1 µg/mL of C max is necessary for CR. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink