Iwasaki T, Hamano T, Aizawa K, Kobayashi K, Kakishita E
Second Department of Internal Medicine, Hyogo College of Medicine.
Ryumachi. 1994 Oct;34(5):885-9.
Mizoribine, a novel immunosuppressive agent developed in Japan, was administered as a monotherapy to a systemic lupus erythematosus (SLE) patient with the clinical symptoms and immunological abnormalities accompanying SLE showing marked improvement. The result of prolonged administration over 22 months in this case showed neither relapse nor side-effects. Reports have been made about mizoribine used concomitantly with steroids in the treatment of SLE; however, there have not been any reports of mizoribine as a monotherapy for SLE being effective. In this case, mizoribine (150 mg/day) was administered without steroids as a monotherapy on a outpatient basis since the patient's condition overall was relatively good and the serious complications of the heart, kidneys, and lungs that accompany SLE were not observed. The results of this treatment showed improvements in alopecia, arthritis, and systemic malaise from about the 4th week after the start of administration, and the clinical symptoms that accompany SLE had completely disappeared in the 8th week. Also, the immunological tests markedly improved. Four months after the start of administration the immunological abnormalities in the anti-DNA antibody, rheumatoid factor, and immune complex were completely corrected. This case showed dramatic improvement in the SLE clinical symptoms and immunological abnormalities with the mizoribine monotherapy as well as the potential for mizoribine monotherapy to maintain a state of remission over the long term.
咪唑立宾是一种在日本研发的新型免疫抑制剂,作为单一疗法用于治疗一名系统性红斑狼疮(SLE)患者,该患者伴有SLE的临床症状和免疫异常,治疗后有显著改善。在该病例中,长达22个月的长期给药结果显示既无复发也无副作用。此前已有关于咪唑立宾与类固醇联合用于治疗SLE的报道;然而,尚无咪唑立宾单一疗法治疗SLE有效的报道。在该病例中,由于患者整体状况相对良好且未观察到SLE伴随的心脏、肾脏和肺部严重并发症,因此在门诊以单一疗法给予患者咪唑立宾(150毫克/天),未使用类固醇。治疗结果显示,给药开始后约第4周,脱发、关节炎和全身不适有所改善,SLE伴随的临床症状在第8周时完全消失。此外,免疫检测也有显著改善。给药开始4个月后,抗DNA抗体、类风湿因子和免疫复合物的免疫异常得到完全纠正。该病例显示,咪唑立宾单一疗法可使SLE临床症状和免疫异常得到显著改善,且咪唑立宾单一疗法有长期维持缓解状态的潜力。