Treatment of membranous nephropathy with mizoribine: A control trial

Membranous nephropathy remains the most common form of the nephrotic syndrome in adults. The combination therapy of steroid and cyclophosphamide has routinely been used. Although satisfactory therapeutic efficacy can be achieved, its side effect on reproductive system has been a concern. Mizoribine is an imidazole nucleoside and a novel immunosuppressant that has been used to treat other immune-related diseases. In this study we examine if the combined regimen of mizoribine and steroid would be advantageous over the use of cyclophosphamide and steroid in treating adult membranous nephropathy.

There were total of fifty-five patients completed the study. These patients had membranous nephropathy with presentation of proteinuria. They were treated with combined regimen of mizoribine and steroid or cyclophosphamide and steroid, and were followed up for one year to monitor safety and efficacy.

We found the condition of proteinuria was significantly improved in the mizoribine group and the improvement was comparable to the patients treated with cyclophosphamide. These patients also exhibited an increase of serum albumin. There was no significant increase of adverse events with the use of mizoribine-based therapy, suggesting the tolerability of mizoribine in adult patients with membranous nephropathy.

In conclusion, the results indicated the satisfactory safety and efficacy of the combination regiment of mizoribine and steroid in treating adult patients with membranous nephropathy.