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First Results From a Propensity Matching Trial of Mycophenolate Mofetil vs. Azathioprine in Treatment-Naive AIH Patients
dc.creator | Dalekos G.N., Arvaniti P., Gatselis N.K., Samakidou A., Gabeta S., Rigopoulou E., Koukoulis G.K., Zachou K. | en |
dc.date.accessioned | 2023-01-31T07:49:16Z | |
dc.date.available | 2023-01-31T07:49:16Z | |
dc.date.issued | 2022 | |
dc.identifier | 10.3389/fimmu.2021.798602 | |
dc.identifier.issn | 16643224 | |
dc.identifier.uri | http://hdl.handle.net/11615/73013 | |
dc.description.abstract | Background/Aims: As previous real-world studies and meta-analyses have shown that mycophenolate mofetil (MMF) might have better efficacy than azathioprine (AZA) in autoimmune hepatitis (AIH), we conducted a propensity matching study to assess the efficacy and safety of MMF vs. AZA. Methods: All 126 consecutive treatment-naive adult AIH patients, diagnosed and followed in our department since 2016, were included. Patients received prednisolone 0.5–1 mg/kg/day plus either AZA 1–2 mg/kg/day or 1.5–2 g/day MMF. The tapering of prednisolone was identical between groups. Results: After propensity matching score and adjustment for known factors affecting response to treatment and outcome, 64 patients were included in the study (MMF = 32 and AZA = 32). Rates of non-response, complete biochemical response (CBR) at 6 and 12 months, and prednisolone withdrawal (6 months, 12 months, and end of follow-up) were identical between groups. However, MMF treatment was significantly associated with CBR at the end of follow-up [odds ratio (OR) 11.259; 95% CI: 1.3–97.4, p = 0.028]. AZA patients were more prone to stop treatment due to AZA intolerance/insufficient response (p = 0.0001). At the end of follow-up, the overall efficacy of each schedule was also significantly higher in the MMF group compared to the AZA group (p = 0.0001). Conclusion: We showed for the first time in a propensity matching study that MMF can be used as first-line therapy in AIH as attested by the significantly higher CBR at end of follow-up compared to AZA. Whether this better efficacy is also associated with higher histological remission rates and sustained CBR off immunosuppression needs further evaluation. Copyright © 2022 Dalekos, Arvaniti, Gatselis, Samakidou, Gabeta, Rigopoulou, Koukoulis and Zachou. | en |
dc.language.iso | en | en |
dc.source | Frontiers in Immunology | en |
dc.source.uri | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85123405734&doi=10.3389%2ffimmu.2021.798602&partnerID=40&md5=4b7299e7178e47d134c63d207042c977 | |
dc.subject | autoantibody | en |
dc.subject | azathioprine | en |
dc.subject | bilirubin | en |
dc.subject | corticosteroid | en |
dc.subject | immunoglobulin G | en |
dc.subject | mycophenolate mofetil | en |
dc.subject | prednisolone | en |
dc.subject | azathioprine | en |
dc.subject | mycophenolic acid | en |
dc.subject | prednisolone | en |
dc.subject | adolescent | en |
dc.subject | adult | en |
dc.subject | aged | en |
dc.subject | aminotransferase blood level | en |
dc.subject | Article | en |
dc.subject | autoimmune hepatitis | en |
dc.subject | autoimmune liver disease | en |
dc.subject | birth control | en |
dc.subject | blood cell count | en |
dc.subject | bone marrow toxicity | en |
dc.subject | cellulitis | en |
dc.subject | clinical trial | en |
dc.subject | comparative effectiveness | en |
dc.subject | controlled study | en |
dc.subject | drug efficacy | en |
dc.subject | drug hypersensitivity | en |
dc.subject | drug overdose | en |
dc.subject | drug withdrawal | en |
dc.subject | enzyme linked immunosorbent assay | en |
dc.subject | female | en |
dc.subject | follow up | en |
dc.subject | gastrointestinal symptom | en |
dc.subject | herpes zoster | en |
dc.subject | histology | en |
dc.subject | human | en |
dc.subject | human cell | en |
dc.subject | human tissue | en |
dc.subject | immunoblotting | en |
dc.subject | immunosuppressive treatment | en |
dc.subject | leukopenia | en |
dc.subject | liver biopsy | en |
dc.subject | liver stiffness | en |
dc.subject | major clinical study | en |
dc.subject | male | en |
dc.subject | middle aged | en |
dc.subject | monotherapy | en |
dc.subject | outcome assessment | en |
dc.subject | physical examination | en |
dc.subject | propensity score | en |
dc.subject | prospective study | en |
dc.subject | remission | en |
dc.subject | respiratory tract infection | en |
dc.subject | risk assessment | en |
dc.subject | sclerosing cholangitis | en |
dc.subject | serology | en |
dc.subject | teratogenicity | en |
dc.subject | thrombocytopenia | en |
dc.subject | transient elastography | en |
dc.subject | treatment outcome | en |
dc.subject | treatment response | en |
dc.subject | very elderly | en |
dc.subject | autoimmune hepatitis | en |
dc.subject | combination drug therapy | en |
dc.subject | statistical model | en |
dc.subject | young adult | en |
dc.subject | Adolescent | en |
dc.subject | Adult | en |
dc.subject | Aged | en |
dc.subject | Aged, 80 and over | en |
dc.subject | Azathioprine | en |
dc.subject | Drug Therapy, Combination | en |
dc.subject | Female | en |
dc.subject | Hepatitis, Autoimmune | en |
dc.subject | Humans | en |
dc.subject | Logistic Models | en |
dc.subject | Male | en |
dc.subject | Middle Aged | en |
dc.subject | Mycophenolic Acid | en |
dc.subject | Prednisolone | en |
dc.subject | Propensity Score | en |
dc.subject | Prospective Studies | en |
dc.subject | Treatment Outcome | en |
dc.subject | Young Adult | en |
dc.subject | Frontiers Media S.A. | en |
dc.title | First Results From a Propensity Matching Trial of Mycophenolate Mofetil vs. Azathioprine in Treatment-Naive AIH Patients | en |
dc.type | journalArticle | en |
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