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咪唑立宾长期治疗狼疮性肾炎的上市后监测研究:2年结果

Post-marketing surveillance study of the long-term use of mizoribine for the treatment of lupus nephritis: 2-Year results.

作者信息

Takeuchi Tsutomu, Okada Kenya, Yoshida Hisao, Yagi Nobuyuki

机构信息

a Division of Rheumatology, Department of Internal Medicine , Keio University School of Medicine , Tokyo , Japan.

b Post-Marketing Surveillance Department , Regulatory Affairs and Reliability Assurance Center, Asahi Kasei Pharma Corporation , Tokyo , Japan.

出版信息

Mod Rheumatol. 2018 Jan;28(1):85-94. doi: 10.1080/14397595.2017.1349573. Epub 2017 Jul 19.

Abstract

OBJECTIVES

To understand the status of mizoribine use in patients with lupus nephritis (LN) and to collect safety- and efficacy-related data on 2-year treatment with mizoribine.

METHODS

A continuous survey was conducted between March 2010 and July 2015.

RESULTS

The analysis set included 559 patients (mean age 39.5 years, females 82.6%, mean duration of systemic lupus erythematosus (SLE) 8.4 years, mean duration of LN 5.9 years). Renal function was satisfactory for 6 months, but worsened from 12 months, with significant worsening at 24 months. By the ACR 2006 remission criteria (eGFR >60), at 24 months, 26.5% of patients achieved complete remission, and 63.3% achieved complete or partial remission. The urine protein to creatinine ratio decreased significantly. The SLE Disease Activity Index 2000 score decreased significantly at 12 and 24 months. Overall, 98 (17.5%) patients experienced 124 adverse drug reactions (ADRs); 3.6% experienced serious ADRs. Mizoribine was used with a steroid in 99.3% and an immunosuppressant in 51.2%; tacrolimus was used in 43.8%. The oral steroid dosage decreased from baseline to 24 months. The incidence of ADRs was not significantly different with concomitant tacrolimus use.

CONCLUSIONS

The results suggest that long-term mizoribine is safe and effective, even when used with tacrolimus.

摘要

目的

了解米唑立宾在狼疮性肾炎(LN)患者中的使用情况,并收集有关米唑立宾2年治疗的安全性和有效性相关数据。

方法

于2010年3月至2015年7月进行了一项连续性调查。

结果

分析集包括559例患者(平均年龄39.5岁,女性占82.6%,系统性红斑狼疮(SLE)平均病程8.4年,LN平均病程5.9年)。肾功能在6个月时良好,但从12个月起恶化,在24个月时显著恶化。根据美国风湿病学会(ACR)2006年缓解标准(估算肾小球滤过率(eGFR)>60),在24个月时,26.5%的患者实现完全缓解,63.3%的患者实现完全或部分缓解。尿蛋白肌酐比值显著下降。SLE疾病活动指数2000评分在12个月和24个月时显著下降。总体而言,98例(17.%)患者发生了124次药物不良反应(ADR);3.6%的患者发生严重ADR。99.3%的患者米唑立宾与类固醇联用,51.2%的患者与免疫抑制剂联用;43.8%的患者使用他克莫司。口服类固醇剂量从基线至24个月减少。联用他克莫司时ADR发生率无显著差异。

结论

结果表明,长期使用米唑立宾是安全有效的,即使与他克莫司联用也是如此。

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