The argument for the use of mizoribine in renal transplantation: A meta-analysis and systemic review

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• 作者：Xin Zhang¹ ; Shangxi Fu¹ ; Shu Han ; Xueyang Zheng ; Liming Wang ; ^{changzhengyizhi@163.com}
• 关键词：AZA ; (azathioprine) ; MMF ; (mycophenolate mofetil) ; MZR ; (mizoribine) ; CsA ; (cyclosporine) ; AR ; (acute rejection) ; RR ; (relative risk) ; CI ; (confidence intervals) ; CMV ; (cytomegalovirus) ; BKV ; (polyomavirus)
• 刊名：Transplant Immunology
• 出版年：2013
• 出版时间：March, 2013
• 年：2013
• 卷：28
• 期：2-3
• 页码：106-111
• 全文大小：987 K

文摘

Objective

The aim of this study is to evaluate the efficacy and safety of mizoribine (MZR) for immunosuppressive therapy in renal transplantation.

Methods

A systematic search of the eligible studies that compared MZR with azathioprine (AZA) for post renal transplant immunosuppressive therapy was performed by using MEDLINE, EMBASE, and the Cochrane Library. Meta-analyses were performed to study the pooled effects of relative risk (RR) and weighted mean difference with 95 % confidence intervals (CI).

Results

A total of 486 participants from seven clinical trials were included. MZR demonstrated comparable efficacy in terms of acute rejection, patient/graft survival, and serum creatinine. However, MZR was associated with a significantly lower incidence of adverse events as compared with AZA (RR 0.39, CI 0.21-0.73, p = 0.003). Specifically, recipients receiving MZR suffered from significantly fewer episodes of myelosuppression (RR 0.12, CI 0.02-0.54, p = 0.006) and leukopenia (RR 0.20, CI 0.06-0.70, p = 0.01). Also, MZR seemed to offer more favorable outcomes in terms of hepatic dysfunction, infection and diabetes, although the differences were not statistically significant.

Conclusions

MZR is a safe, well-tolerated and effective immunosuppressive agent that can be recommended as an alternative to AZA in renal transplant recipients, although further studies are needed to balance its effect with mycophenolate mofetil.