Excellent Results of High-Dose Mizoribine Combined With Cyclosporine, Basiliximab, and Corticosteroids in Renal Transplant Recipients¡ª4-Year Results

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• 作者：N. Yoshimura^a ; ^b ; ^{nyoshi@koto.kpu-m.ac.jp} ; H. Ushigome^a ; S. Nobori^a ; T. Suzuki^a ; K. Sakai^a ; K. Koshino^a ; H. Okajima^a ; ^b ; M. Okamoto^a ; ^b
• 刊名：Transplantation Proceedings
• 出版年：2013
• 出版时间：May, 2013
• 年：2013
• 卷：45
• 期：4
• 页码：1472-1475
• 全文大小：462 K

文摘

Background

Mizoribine (MZR) at 3 mg/kg/d shows less potent immunosuppressive effects, but high-dose MZR (6 mg/kg/d) was effective and safe in a 2-year study in conjunction with a regimen of cyclosporine (CsA), basiliximab, and corticosteroids.

Methods

We compared 40 living-related kidney recipients administered MZR (6 mg/kg/d), CsA (7 mg/kg/d), prednisolone (maintenance dose 10 mg/d), and basiliximab (20 mg/body) with control group (n = 38) treated with CsA, mycophenolate mofetil (MMF; 25 mg/kg/d), basiliximab, and corticosteroids.

Results

The 4-year graft survival rates for the MZR vs MMF groups were 92.5 % vs 94.7 % , respectively, with serum creatinine levels of 1.66 ¡À 1.0 mg/dL vs 1.41 ¡À 0.42 mg/dL at 3 years, and 1.72 ¡À 1.16 mg/dL vs 1.56 ¡À 1.26 mg/dL at 4 years. There was no significant difference in serum creatinine levels between the 2 groups. The MZR group demonstrated a significantly higher rate of elevated serum uric acid values (29.7 % ). The numbers of patients treated with allopurinol at 4 years were 11/37 (29.7 % ) for MZR vs 2/36 (5.6 % ) for the MMF subjects (P < .05). Mean serum uric acid levels of the MZR vs MMF group at 4 years were 7.1 ¡À 1.9 mg/dL vs 7.0 ¡À 1.6 mg/dL, respectively (NS). There was no significant difference between the 2 groups regarding bone marrow suppression or liver dysfunction. Severe cytomegalovirus infection was not observed at 3 and 4 years in either group. There were no severe gastrointestinal symptoms among the MZR or the MMF group at 3 or 4 years.

Conclusions

The combination of high-dose MZR with CsA, basiliximab, and corticosteroids displayed excellent results over a 4-year follow-up.