PMID- 18224343
OWN - NLM
STAT- MEDLINE
DCOM- 20081021
LR  - 20211020
IS  - 0931-041X (Print)
IS  - 0931-041X (Linking)
VI  - 23
IP  - 5
DP  - 2008 May
TI  - Combination therapy with mizoribine for severe childhood IgA nephropathy: a pilot 
      study.
PG  - 757-63
LID - 10.1007/s00467-007-0731-8 [doi]
AB  - 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/m(2)/day to 0.05 g/m(2)/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.
FAU - Yoshikawa, Norishige
AU  - Yoshikawa N
AD  - Department of Pediatrics, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 
      Japan. nori@wakayama-med.ac.jp
FAU - Nakanishi, Koichi
AU  - Nakanishi K
FAU - Ishikura, Kenji
AU  - Ishikura K
FAU - Hataya, Hiroshi
AU  - Hataya H
FAU - Iijima, Kazumoto
AU  - Iijima K
FAU - Honda, Masataka
AU  - Honda M
CN  - Japanese Pediatric IgA Nephropathy Treatment Study Group
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20080126
PL  - Germany
TA  - Pediatr Nephrol
JT  - Pediatric nephrology (Berlin, Germany)
JID - 8708728
RN  - 0 (Glucocorticoids)
RN  - 0 (Immunoglobulin A)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Ribonucleosides)
RN  - 4JR41A10VP (mizoribine)
RN  - 64ALC7F90C (Dipyridamole)
RN  - 9PHQ9Y1OLM (Prednisolone)
RN  - EC 1.1.1.205 (IMP Dehydrogenase)
SB  - IM
MH  - Biopsy
MH  - Child
MH  - Dipyridamole/therapeutic use
MH  - Disease Progression
MH  - Female
MH  - Follow-Up Studies
MH  - Glomerulonephritis, IGA/*drug therapy/metabolism/pathology
MH  - Glucocorticoids/*therapeutic use
MH  - Humans
MH  - IMP Dehydrogenase/antagonists & inhibitors
MH  - Immunoglobulin A/blood
MH  - Immunosuppressive Agents/*therapeutic use
MH  - Kidney Glomerulus/*pathology
MH  - Male
MH  - Pilot Projects
MH  - Platelet Aggregation Inhibitors/*therapeutic use
MH  - Prednisolone/therapeutic use
MH  - Prospective Studies
MH  - Proteinuria/pathology/urine
MH  - Ribonucleosides/*therapeutic use
MH  - Severity of Illness Index
MH  - Treatment Outcome
FIR - Ito, H
IR  - Ito H
FIR - Yoshikawa, N
IR  - Yoshikawa N
FIR - Kawamura, T
IR  - Kawamura T
FIR - Hoshii, S
IR  - Hoshii S
FIR - Kawamura, K
IR  - Kawamura K
FIR - Honda, M
IR  - Honda M
FIR - Ikeda, M
IR  - Ikeda M
FIR - Hataya, H
IR  - Hataya H
FIR - Ishikura, K
IR  - Ishikura K
FIR - Iijima, K
IR  - Iijima K
FIR - Ito, S
IR  - Ito S
FIR - Nakanishi, K
IR  - Nakanishi K
FIR - Nozu, K
IR  - Nozu K
FIR - Furuse, A
IR  - Furuse A
EDAT- 2008/01/29 09:00
MHDA- 2008/10/22 09:00
CRDT- 2008/01/29 09:00
PHST- 2007/10/02 00:00 [received]
PHST- 2007/11/27 00:00 [accepted]
PHST- 2007/11/19 00:00 [revised]
PHST- 2008/01/29 09:00 [pubmed]
PHST- 2008/10/22 09:00 [medline]
PHST- 2008/01/29 09:00 [entrez]
AID - 10.1007/s00467-007-0731-8 [doi]
PST - ppublish
SO  - Pediatr Nephrol. 2008 May;23(5):757-63. doi: 10.1007/s00467-007-0731-8. Epub 2008 
      Jan 26.