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Effect of mizoribine pulse therapy in adult membranous nephropathy
Xichao Wang1, Miaomiao Zhang1, Wenyu Zhang1
1Department of Nephrology, Tianjin First Central Hospital, No.24 Fukang Road, Tianjin, 300192, China.
Abstract:
Membraneous nephropathy (MN) is one of the complicated kidney diseases associated with proteinuria. Mizoribine (MZR) is an emerging treatment option for nephrotic syndrome; however, its dosage and administration are yet lack of consensus. This study aims to evaluate the efficacy and safety of high-dose MZR pulse therapy for adult membraneous nephropathy. Sixty patients with membraneous nephropathy were recruited, and assigned to two treatment groups. One group received conventional treatment of steroid combining with cyclophosphamide (CPM), the other group received steroid combining with high-dose MZR pulse administration. Both groups were followed up for 1 year. Treatment efficacy and side effects were measured regularly. Fifty-nine patients completed the treatment courses. There was no significant difference in demographic and disease conditions prior to treatment between two treatment groups. Both groups showed significant decrease of urine proteins and increase of serum albumin levels after treatments with no severe side effects. After 6 months of treatment, MZR group has 71% reduction (compared to 74.4% reduction in CPM group) in urine protein compared to baseline after adjusting for age and gender. 89.7% of patients in CPM and 93.3% in MZR groups had partial/ complete remission after 12 months. This study demonstrated satisfactory safety and efficacy of high-dose mizoribine pulse administration combining with steroid treatment for adult patients with membranous nephropathy.
Insights
High-dose mizoribine (MZR) pulse therapy, combined with steroids, shows comparable efficacy and safety to cyclophosphamide (CPM) for treating adult membranous nephropathy (MN). Both treatments effectively reduced proteinuria and improved albumin levels over one year.
Area of Science:
- Nephrology
- Immunosuppressive therapy
- Glomerular diseases
Background:
- Membranous nephropathy (MN) is a leading cause of nephrotic syndrome in adults, characterized by proteinuria.
- Current treatment strategies for MN lack universal consensus, particularly regarding optimal immunosuppressive regimens.
- Mizoribine (MZR) is an emerging immunosuppressant, but its high-dose pulse administration for MN requires further evaluation.
Purpose of the Study:
- To assess the efficacy and safety of high-dose mizoribine (MZR) pulse therapy combined with steroids in adult patients with membranous nephropathy (MN).
- To compare the outcomes of MZR pulse therapy with the conventional treatment of steroids plus cyclophosphamide (CPM).
Main Methods:
- A prospective study involving 60 adult patients diagnosed with membranous nephropathy (MN).
- Patients were randomized into two groups: one receiving steroid plus cyclophosphamide (CPM) and the other receiving steroid plus high-dose mizoribine (MZR) pulse therapy.
- Treatment efficacy (urine protein, serum albumin) and safety (side effects) were monitored over a 1-year follow-up period.
Main Results:
- Both treatment groups demonstrated significant reductions in proteinuria and improvements in serum albumin levels without severe adverse events.
- After 6 months, the MZR group showed a 71% reduction in urine protein compared to baseline, similar to the 74.4% reduction in the CPM group.
- After 12 months, partial or complete remission was achieved in 93.3% of patients in the MZR group and 89.7% in the CPM group.
Conclusions:
- High-dose mizoribine (MZR) pulse administration combined with steroid treatment is a safe and effective therapeutic option for adult patients with membranous nephropathy (MN).
- MZR pulse therapy offers comparable efficacy to the conventional cyclophosphamide (CPM) regimen in managing MN.
- Further research may establish MZR pulse therapy as a viable alternative treatment for MN.
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