Evidence map›Paper›PMID 41995998›Full record

SynthesisRheumatology and therapy2026

Efficacy and Safety of Mizoribine in the Treatment of Lupus Nephritis: A Systematic Review and Meta-Analysis.

Xingyun Wan, Xiaolong Wang, Shuang Liang, Qian Wang, Chao Liu, Zheyi Dong

Abstract readSystematic Review
In one paragraph

Synthesis in Rheumatology and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Xingyun Wan *Boao Shu Lan Hospital, Qionghai, China.
Xiaolong Wang *Department of Nephrology, First Medical Center of Chinese PLA General Hospital, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Prevention and Treatment of Pan-Vascular Diseases, Fuxing Road No. 28, Beijing, 100853, China.
Shuang LiangDepartment of Nephrology, First Medical Center of Chinese PLA General Hospital, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Prevention and Treatment of Pan-Vascular Diseases, Fuxing Road No. 28, Beijing, 100853, China.
Qian WangDepartment of Nephrology, First Medical Center of Chinese PLA General Hospital, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Prevention and Treatment of Pan-Vascular Diseases, Fuxing Road No. 28, Beijing, 100853, China.
Chao LiuDepartment of Critical Care Medicine, First Medical Center of Chinese, PLA General Hospital, Fuxing Road No. 28, Beijing, China. chaoliu301@foxmail.com.
Zheyi DongDepartment of Nephrology, First Medical Center of Chinese PLA General Hospital, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Prevention and Treatment of Pan-Vascular Diseases, Fuxing Road No. 28, Beijing, 100853, China. shengdai26@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis study evalöuated the clinical efficacy and safety of mizoribine (MZR) in the treatment of lupus nephritis.

methodsWe conducted a systematic review and meta-analysis in accordance with PRISMA 2020 guidelines. Literature searches were performed in PubMed, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov up to June 30, 2025. Two investigators independently screened studies, extracted data, and assessed risk of bias. Included studies enrolled patients with biopsy-confirmed lupus nephritis treated with mizoribine-containing regimens, including randomized controlled trials (RCTs), cohort studies, and single-arm designs. Primary and secondary outcomes were renal response rate (The proportion of patients achieving either complete response (CR) and partial response (PR). CR: 24-h urinary protein < 0.5 g/day with normal/stable serum creatinine ≤ 25%. PR: ≥ 50% reduction in proteinuria to < 3.5 g/day with stable serum creatinine ≤ 25%), and adverse reaction rate, 24-h urinary protein, and systemic lupus erythematosus disease activity index (SLEDAI) score, respectively. Data were analyzed in STATA 14.0 using fixed or random-effects models based on heterogeneity (random effects for I

resultsNineteen studies (four RCTs, one cohort, 14 single-arm) with 1489 patients were included. Meta-analysis of randomized controlled trials (RCTs) showed no significant differences in renal response rates or adverse reaction rates between MZR and control groups, but a higher SLEDAI score was observed with MZR (WMD = 1.75, 95% CI 0.33-3.16, P < 0.05). Subgroup analysis indicated MZR was associated with a reduced renal response rates (RR = 0.83, 95% CI 0.71-0.97, P < 0.05), elevated proteinuria (WMD = 0.62, 95% CI 0.22-1.03, P < 0.05), and higher SLEDAI scores (WMD = 1.75, 95% CI 0.33-3.16, P < 0.05) versus controls. These negative outcomes, including increased proteinuria (WMD = 0.73, 95% CI 0.11-1.36, P < 0.05) and SLEDAI (WMD = 2.60, 95% CI 1.19-4.01, P < 0.05), were significant only in the induction period use (P < 0.05) and not sustained maintenance period (> 6 months). Single-arm studies reported high response rates (59-100%) but widely variable adverse reaction rates (5-50%). The types of adverse events included hyperuricemia, respiratory tract infection, leukopenia, etc.

conclusionsMizoribine demonstrates phased efficacy in lupus nephritis: it is less effective than standard regimens for the induction period (≤ 6 months) but comparable during the maintenance period (> 6 months). Therefore, it is not a first-line induction agent but serves as a practical maintenance option, particularly for patients intolerant of conventional therapies or in resource-limited settings.

Indexed as

Lupus nephritisMeta-analysisMizoribineRenal response rateSystematic review

Identifiers

PMID41995998
PMCPMC13198567

What Socratic holds

Textmetadata
LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.