The safety and efficacy of combination therapy of cyclosporine A and mizoribine for children with frequently relapsing steroid-dependent nephrotic syndrome.

Abstract

We report a retrospective study of the safety and efficacy of combination therapy of Cyclosporine A (CsA) and Mizoribine (MZR) for children with frequently relapsing steroid-dependent nephrotic syndrome (FR-SDNS). The subjects were 20 patients with FR-SDNS treated with combination therapy of CsA and MZR in this retrospective analysis. Only one patient experienced mild hyperuricemia, known to be one of the most common side effects of mizoribine. No other adverse effects were noted in the rest of the patients. Nine out of 20 patients treated with CsA only for at least 6months followed by the combination therapy of CsA and MZR for at shortest 6months were analyzed for total prednisolone (PSL) dose and incidence of relapse to compare before and after the combination therapy. The treatment with combination therapy over a period of 10.1 months (median) resulted in significant reduction of the mean prednisolone dose from 0.37±0.28 to 0.15±0.15 mg/kg/day (p=0.016) and the median 6-month relapse rate from 1.7±0.9 to 0.8±0.7 episodes/6months (p<0.01). The combination therapy of CsA and MZR could be one of treatment choices for patients with FR-SDNS