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Erschienen in: Pediatric Nephrology 5/2008

01.05.2008 | Original Article

Combination therapy with mizoribine for severe childhood IgA nephropathy: a pilot study

verfasst von: Norishige Yoshikawa, Koichi Nakanishi, Kenji Ishikura, Hiroshi Hataya, Kazumoto Iijima, Masataka Honda, For the Japanese Pediatric IgA Nephropathy Treatment Study Group

Erschienen in: Pediatric Nephrology | Ausgabe 5/2008

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Abstract

In two previous randomized controlled trials we showed that treatment of severe childhood immunoglobulin A nephropathy (IgA-N) using prednisolone, azathioprine, heparin–warfarin, and dipyridamole prevented any increase of sclerosed glomeruli and that prednisolone alone did not prevent a further increase of sclerosed glomeruli. Accordingly, the immunosuppressant is considered to be important. Often, however, we were unable to complete azathioprine regimen due to toxicity. Therefore, a different but effective immunosuppressant may be worth trying. Mizoribine, like azathioprine, is an antimetabolite that exerts its immunosuppressant effect by inhibiting lymphocyte proliferation. In this pilot study, we administered mizoribine instead of azathioprine as part of the combination therapy for treating 23 children with severe IgA-N and evaluated the efficacy and safety. Eighteen patients reached the primary endpoint (urine protein/creatinine ratio <0.2) during the 2-year treatment period. The cumulative disappearance rate of proteinuria determined by Kaplan–Meier was 80.4%. Median protein excretion was reduced from 1.19 g/m2/day to 0.05 g/m2/day (p < 0.0001). After treatment, the median percentage of glomeruli showing sclerosis was unchanged in comparison with that before treatment. No patients required a change of treatment. In conclusion, the efficacy and safety of the mizoribine combination seems to be acceptable for treating children with severe IgA-N.
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Metadaten
Titel
Combination therapy with mizoribine for severe childhood IgA nephropathy: a pilot study
verfasst von
Norishige Yoshikawa
Koichi Nakanishi
Kenji Ishikura
Hiroshi Hataya
Kazumoto Iijima
Masataka Honda
For the Japanese Pediatric IgA Nephropathy Treatment Study Group
Publikationsdatum
01.05.2008
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Nephrology / Ausgabe 5/2008
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-007-0731-8

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