A RANDOM TRIAL OF MIZORIBINE VERSUS MYCOPHENOLATE MOFETIL IN TACROLIMUS-BASED RENAL TRANSPLANTATION

Abstract

A61 Aims: Mycophenolate mofetile (MMF) and Mizoribine (MZ) are immunosuppressive drugs that impair de novo purine synthesis. Some recent papers reported the efficacy and safety of MZ with Cyclosporine (CsA) and those of MMF with Tacrolimus (FK506) in renal transplantation. However, there have been no reports comparing MZ and MMF with the FK506-based immunosuppression for renal transplant recipients. This study was designed to investigate the safety and efficacy of MZ and FK506 compared to MMF and FK506 for renal transplant recipients. Methods: From November 1999 to February 2003, there were 37 recipients (28 male, 9 female) entered into this trial. All patients received donor specific blood transfusion (DST) prior to transplantation, and they were transplanted from living donors. From the day of transplantation, 5mg/kg/day of Deoxyspergualin (DSG) was administered for one week, followed by MZ or MMF. MZ or MMF was administered on 5mg/kg/day, 1g b.i.d., respectively; 18 patients were in the MZ group (14 male, 4 female), and 19 patients were in the MMF group (14 male, and 5 female). Results: Rejection (biopsy proven): CMV Infection: There were four cases of CMV infection (4/18: 22%) in the MZ group; however, the MMF group had seven cases of CMV infection (7/19: 38%). Polyoma Infection: Each group had one case of polyoma infection (the MZ group 1/18: 6%; the MMF group 1/19: 5%). Gastrointestinal disorder: There was more diarrhea in the MMF group (4 cases, 21%) than in the MZ group (1 case, 6%). Crossover: Three cases were forced to change from MZ to MMF due to steroid-resistant acute rejection. Conclusions: 1. Although this was a small-scale study, there were no significant differences between the MZ and MMF groups in the frequency of acute rejection. 2. There was more CMV infection in the MMF group than in the MZ group. 3. Further investigation is required, however, MZ and MMF are both useful immunosuppressive agents.Figure