Efficacy of mizoribine in renal transplant recipients on calcineurin inhibitor-based immunosuppression: a network meta-analysis

In CNI-based maintenance therapy for renal transplant recipients, MZR is equivalent to MPA and MMF in ensuring long-term patient and graft survival. It exhibits a distinct safety profile: significantly superior gastrointestinal tolerability and a lower risk of leukopenia, albeit with a potentially higher risk of BK viremia. In terms of renal function, MZR demonstrates an intermediate effect, superior to MMF but inferior to CTX. Clinical selection should involve weighing the risks of infection (particularly BK virus) against gastrointestinal tolerability based on individual patient characteristics. MZR represents an effective and well-tolerated important alternative to traditional MMF/MPA.