dc.creator | Zachou, K. | en |
dc.creator | Gatselis, N. | en |
dc.creator | Papadamou, G. | en |
dc.creator | Rigopoulou, E. I. | en |
dc.creator | Dalekos, G. N. | en |
dc.date.accessioned | 2015-11-23T10:54:36Z | |
dc.date.available | 2015-11-23T10:54:36Z | |
dc.date.issued | 2011 | |
dc.identifier | 10.1016/j.jhep.2010.12.032 | |
dc.identifier.issn | 1688278 | |
dc.identifier.uri | http://hdl.handle.net/11615/34779 | |
dc.description.abstract | Background & Aims: Standard therapy for autoimmune hepatitis (AIH) is corticosteroids with or without azathioprine. However, 20% of patients do not respond or are intolerant to conventional treatment. Therefore, we evaluated prospectively the efficacy and safety of mycophenolate mofetil (MMF) in inducing and/or maintaining remission in treatment-naïve AIH patients. Methods: Fifty-nine treatment-naïve patients with well defined AIH were treated with prednisolone plus 1.5-2 g/d of MMF. Patients were candidates for MMF withdrawal after at least 4 years. Treatment outcomes were defined according to the International Autoimmune Hepatitis Group report. Results: Treatment duration with MMF was 26 months (range 3-92). Eighty-eight percent (52/59) of patients responded initially clinically and biochemically (normalization of transaminases and γ-globulins) most of them within 3 months. The remaining 7 patients (12%) had partial response. In total, 59.3% (35/59) of patients had complete response (CR) with 37% (22/59) of them having achieved CR off prednisolone, while 28.8% (17/59) had initial CR with relapses. No patient was non-responder. Prednisolone withdrew in 57.6% (34/59) of patients in 8 months. The only independent predictor of treatment outcome, was γ-GT (baseline γ-GT, p = 0.008 and γ-GT on month 24, p <0.05). Severe side effects leading to MMF discontinuation occurred in only 3.4% (2/59) of patients. Six patients (2 according to protocol and 4 for personal reasons), stopped treatment with MMF, but 3 relapsed. Conclusions: MMF seems safe and effective as first-line therapy in inducing and maintaining remission in treatment-naive patients with AIH, having a significant and rapid steroid sparing effect as attested by the fact that so far, 37% (22/59) of AIH patients achieved CR off prednisolone. © 2011 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved. | en |
dc.source.uri | http://www.scopus.com/inward/record.url?eid=2-s2.0-84860389502&partnerID=40&md5=50e821af43d62491b60c4f598c54f94e | |
dc.subject | Autoimmune hepatitis | en |
dc.subject | Cirrhosis | en |
dc.subject | Liver autoimmunity | en |
dc.subject | Mycophenolate mofetil | en |
dc.subject | aminotransferase | en |
dc.subject | corticosteroid | en |
dc.subject | immunoglobulin | en |
dc.subject | mycophenolic acid | en |
dc.subject | prednisolone | en |
dc.subject | steroid | en |
dc.subject | adult | en |
dc.subject | aged | en |
dc.subject | article | en |
dc.subject | biochemistry | en |
dc.subject | cohort analysis | en |
dc.subject | drug dose increase | en |
dc.subject | drug dose reduction | en |
dc.subject | drug efficacy | en |
dc.subject | drug safety | en |
dc.subject | drug tolerability | en |
dc.subject | drug withdrawal | en |
dc.subject | female | en |
dc.subject | gastrointestinal symptom | en |
dc.subject | hematologic disease | en |
dc.subject | human | en |
dc.subject | human tissue | en |
dc.subject | major clinical study | en |
dc.subject | male | en |
dc.subject | patient compliance | en |
dc.subject | prediction | en |
dc.subject | priority journal | en |
dc.subject | prospective study | en |
dc.subject | relapse | en |
dc.subject | remission | en |
dc.subject | septicemia | en |
dc.subject | treatment duration | en |
dc.subject | treatment outcome | en |
dc.subject | Anti-Inflammatory Agents | en |
dc.subject | Drug Therapy, Combination | en |
dc.subject | gamma-Glutamyltransferase | en |
dc.subject | Hepatitis, Autoimmune | en |
dc.subject | Humans | en |
dc.subject | Immunosuppressive Agents | en |
dc.subject | Middle Aged | en |
dc.subject | Prospective Studies | en |
dc.subject | Recurrence | en |
dc.subject | Remission Induction | en |
dc.subject | Time Factors | en |
dc.title | Mycophenolate for the treatment of autoimmune hepatitis: Prospective assessment of its efficacy and safety for induction and maintenance of remission in a large cohort of treatment-naïve patients | en |
dc.type | journalArticle | en |