Clinical efficacy of mizoribine in treatment of active systemic lupus erythematosus.

doi:10.7504/nk2014050401

Acta Metallurgica Sinica

Previous Articles Next Articles

Clinical efficacy of mizoribine in treatment of active systemic lupus erythematosus.

GU Fei*，FENG Xue-bing，CHEN Wei-wei，LIU Yan，WEI Hua，LIU Lin，YIN Song-lou，DA Zhan-yun，SUN Ling-yun.

*Department of Rheumatology and Immunology，the Affiliated Drum Tower Hospital of Nanjing University Medical School，Nanjing 210008，China

Online:2014-06-01 Published:2014-06-03

咪唑立宾治疗活动性系统性红斑狼疮疗效分析

顾菲1，冯学兵1，陈纬纬1，刘焱2，魏华3，刘琳4，殷松楼5，达展云6，孙凌云1

作者单位：1.南京大学医学院附属鼓楼医院风湿免疫科，南京 210008 (顾菲、冯学兵为共同第一作者)；2.淮安第一人民医院风湿科，江苏淮安 223300；3.苏北人民医院风湿免疫科，江苏扬州 225001；4.徐州中心医院风湿免疫科，江苏徐州 221009；5.徐州医学院附属医院风湿免疫科，江苏徐州 221002；6.南通大学附属医院风湿免疫科，江苏南通 226001

通讯作者: 孙凌云
基金资助:
国家自然科学基金青年科学基金项目(81302557)；中华医学会临床医学科研专项基金(12040720372)；南京市青年科技人才启动项目(QYK09173)

Abstract

Abstract:

Abstract：Objective To evaluate the efficacy and safety of mizoribine (MZR) for active systemic lupus erythematosus (SLE) in comparison with mycophenolate mofetil (MMF) and cyclophosphamide (CYC).Methods Ninety patients with active SLE were enrolled between April 2012 and March 2013.Thirty patients were given MZR orally at a dose of 300 mg every other day.Thirty patients were taken MMF at 2 g per day in two divided doses.Thirty patients received 0.5 g CYC intravenously every two weeks.Therapeutic effects and adverse events (AEs) were evaluated at the end of 24-week treatment.Results The overall response rates of MZR，MMF and CYC group were 75.86%，78.58%，and 79.31% at week 24 respectively.In MZR，MMF and CYC group，34.48%，39.29%，and 37.93% patients achieved complete remission respectively.There was no significant difference in the overall response rates or complete remission rates among the three groups.SLEDAI scores，24-hour proteinuria and anti-dsDNA titer significantly decreased in all the three groups.All of the three treatments significantly increased leukocyte counts，hemoglobin levels，platelet counts，and serum complement C3 and C4 levels.No significant difference was observed in the parameters above among the three groups.The incidences of AEs in patients treated with MZR or MMF were significantly lower than those in patients treated with CYC.Conclusion MZR is well tolerated and has an effect similar to MMF or CYC in the treatment of active SLE，which may serve as a novel and alternative approach for SLE patients.

Key words: mizoribine；mycophenolate mofetil；cyclophosphamide；lupus erythematosus, systemic

摘要：

目的以霉酚酸酯(MMF)及环磷酰胺(CYC)为对照，评价咪唑立宾(MZR)治疗活动性系统性红斑狼疮(SLE)的疗效和安全性。方法以中国江苏6家研究中心2012年4月至2013年3月收治的90例活动性SLE患者为研究对象。将其随机分为MZR组、MMF组和CYC组。其中MZR组30例，口服MZR 300 mg，隔日1次；MMF组30例，口服MMF 1 g，每日2次；CYC组30例，静脉用CYC 0.5 g，每2周1次。治疗24周后评估疗效和不良反应事件。结果 MZR组、MMF组、CYC组的总有效率分别为75.86%、78.58%和79.31%，完全缓解率分别为34.48%、39.29%和37.93%，3组总有效率和完全缓解率比较差异无统计学意义。治疗后3组患者SLEDAI积分、24 h尿蛋白定量、抗dsDNA抗体滴度均显著下降；3组患者的外周血白细胞计数、血红蛋白含量、血小板计数均明显上升；3种治疗均可明显提高患者血清C3、C4水平；以上各观察指标组间比较差异均无统计学意义。MZR组、MMF组不良事件发生率明显低于CYC组。结论 MZR治疗活动性SLE的疗效与MMF、CYC相当且耐受性较好，可以作为治疗SLE患者的全新治疗药物。

关键词: 咪唑立宾；霉酚酸酯；环磷酰胺；红斑狼疮, 系统性

CLC Number:

R593.24+1

GU Fei*，FENG Xue-bing，CHEN Wei-wei，LIU Yan，WEI Hua，LIU Lin，YIN Song-lou，DA Zhan-yun，SUN Ling-yun.. Clinical efficacy of mizoribine in treatment of active systemic lupus erythematosus.[J]. Acta Metallurgica Sinica, DOI: 10.7504/nk2014050401.

顾菲1，冯学兵1，陈纬纬1，刘焱2，魏华3，刘琳4，殷松楼5，达展云6，孙凌云1. 咪唑立宾治疗活动性系统性红斑狼疮疗效分析[J]. 中国实用内科杂志, DOI: 10.7504/nk2014050401.

References

［1］蒋明，D Yu，林孝义，等.中华风湿病学［M］.北京：华夏出版社，2004：933-952.

［2］Hochberg MC.Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus［J］.Arthritis Rheum，1997，40(9)：1725.

［3］顾越英.系统性红斑狼疮诊治指南 (草案)［J］.中华风湿病学杂志，2003，7(8)：508-513.

［4］张文，李芹.五种系统性红斑狼疮活动指数的比较［J］.中华风湿病学杂志，2001，5(1)：35-38.

［5］Appel GB，Contreras G，Dooley MA，et al.Mycophenolate mofetil versus cyclophosphamide for induction treatment of lupus nephritis［J］.J Am Soc Nephrol，2009，20(5)：1103-1112.

［6］Ong LM，Hooi LS，Lim TO，et al.Randomized controlled trial of pulse intravenous cyclophosphamide versus mycophenolate mofetil in the induction therapy of proliferative lupus nephritis［J］.Nephrology (Carlton)，2005，10(5)：504-510.

［7］Chan TM，Tse KC，Tang CS，et al.Long-term study of mycophenolate mofetil as continuous induction and maintenance treatment for diffuse proliferative lupus nephritis［J］.J Am Soc Nephrol，2005，16(4)：1076-1084.

［8］Hu W，Liu Z，Chen H，et al.Mycophenolate mofetil vs cyclophosphamide therapy for patients with diffuse proliferative lupus nephritis［J］.Chin Med J (Engl)，2002，115(5)：705-709.

［9］Lightstone L.Lupus nephritis：where are we now?［J］.Curr Opin Rheumatol，2010，22(3)：252-256.

［10］Kawasaki Y.Mizoribine：a new approach in the treatment of renal disease［J］.Clin Dev Immunol，2009，2009：681482.

［11］Kamata K，Okubo M，Uchiyama T，et al.Effect of mizoribine on lupus nephropathy of New Zealand black/white F1 hybrid mice［J］.Clin Immunol Immunopathol，1984，33(1)：31-38.

［12］Nishi E，Kameda H，Ogawa H，et al.Efficacy of weekly mizoribine pulse therapy in refractory lupus nephritis［J］.Mod Rheumatol，2013，23(1)：97-103.

［13］Nozu K，Iijima K，Kamioka I，et al.High-dose mizoribine treatment for adolescents with systemic lupus erythematosus［J］.Pediatr Int，2006，48(2)：152-157.

［14］Yumura W，Suganuma S，Uchida K，et al.Effects of long-term treatment with mizoribine in patients with proliferative lupus nephritis［J］.Clin Nephrol，2005，64(1)：28-34.

［15］Zhang M，Xing CY，Liu J.Study of the efficacy of mizoribine in lupus nephritis in Chinese patients［J］.Rheumatol Int，2013，33(11)：2737-2742.

［16］Tanaka H，Oki E，Tsuruga K，et al.Mizoribine attenuates renal injury and macrophage infiltration in patients with severe lupus nephritis［J］.Clin Rheumatol，2010，29(9)：1049-1054.

［17］袁敏，丁小强.狼疮性肾炎治疗中的感染问题［J］.中国实用内科杂志，2009，29(6)：509-512.

［18］谌贻璞.肾上腺糖皮质激素在狼疮性肾炎治疗中的合理应用［J］.中国实用内科杂志，2009，29(6)：496-498.

［19］Kuramoto T，Daikoku T，Yoshida Y，et al.Novel anticytomegalovirus activity of immunosuppressant mizoribine and its synergism with ganciclovir［J］.J Pharmacol Exp Ther，2010，333(3)：816-821.

［20］Naka K，Ikeda M，Abe K，et al.Mizoribine inhibits hepatitis C virus RNA replication：effect of combination with interferon-alpha［J］.Biochem Biophys Res Commun，2005，330(3)：871-879.

2014-03-12收稿 2014-04-01修回本文编辑：颜廷梅

[1]	. [J]. Acta Metallurgica Sinica, 2014, 34(9): 926-927.
[2]	ZHU Yin，L Nong-hua.. Early management of severe acute pancreatitis. [J]. Acta Metallurgica Sinica, 2014, 34(9): 839-842.
[3]	QIU Xiao-hua,QIU Hai-bo.. Severe infection：from phenomenon to essence and from evaluation to treatment [J]. Acta Metallurgica Sinica, 2014, 34(8): 733-736.
[4]	ZHOU Xu-jie，ZHANG Hong. Current status on genetic research of lupus nephritis [J]. Acta Metallurgica Sinica, 2014, 34(3): 247-250.
[5]	. [J]. Acta Metallurgica Sinica, 2014, 34(10): 1034-1035.
[6]	LI Lan，LI You-ming.. Management of refractory ascites in liver cirrhosis. [J]. Acta Metallurgica Sinica, 2013, 33(9): 676-678.
[7]	FU Ping，QIN Wei. Treatment of lupus nephritis:interpretation of KDIGO guideline. [J]. , 2012, 32(12): 921-924.

Clinical efficacy of mizoribine in treatment of active systemic lupus erythematosus.

咪唑立宾治疗活动性系统性红斑狼疮疗效分析

PDF

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 7

Recommended Articles

Metrics