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A real-world study focused on the long-term efficacy of mycophenolate mofetil as first-line treatment of autoimmune hepatitis
dc.creator | Zachou K., Gatselis N.K., Arvaniti P., Gabeta S., Rigopoulou E.I., Koukoulis G.K., Dalekos G.N. | en |
dc.date.accessioned | 2023-01-31T11:38:07Z | |
dc.date.available | 2023-01-31T11:38:07Z | |
dc.date.issued | 2016 | |
dc.identifier | 10.1111/apt.13584 | |
dc.identifier.issn | 02692813 | |
dc.identifier.uri | http://hdl.handle.net/11615/80923 | |
dc.description.abstract | Background Front-line therapy with mycophenolate mofetil (MMF) in autoimmune hepatitis (AIH) has shown high on-treatment remission rates. Aim To study prospectively in a real-world fashion the long-term outcome of a large group of consecutive treatment-naïve AIH patients. Methods Between 2000 and 2014, 158 patients were recruited but only 131 were eligible for treatment (109 MMF/prednisolone; 22 prednisolone ± azathioprine). Long-term data on outcome after drug withdrawal were evaluated. Patients stopped treatment after having achieved complete response (normal transaminases and IgG) for at least the last 2 years. Results At diagnosis, 31.6% of patients had cirrhosis and 72.8% insidious presentation. A total of 102 of 109 (93.6%) responded initially to MMF within 2 (1-18) months. A total of 78 of 109 (71.6%) had complete response on treatment and 61 of 78 (78.2%) maintained remission off prednisolone. MMF-treated patients had increased probability of complete response compared to those receiving azathioprine (P = 0.03). Independent predictors of complete response were lower ALT at 6 months (P = 0.001) and acute presentation (P = 0.03). So far, treatment withdrawal was feasible in 40/109 patients and 30 (75%) are still in remission after 24 (2-129) months. Remission maintenance was associated with longer MMF treatment (P = 0.005), higher baseline ALT (P < 0.02), lower IgG on 6 months (P = 0.004) and histological improvement. Conclusions Mycophenolate mofetil proved to be an efficient first-line treatment for AIH, achieving so far the highest rates of remission maintenance off treatment (75%) ever published for at least a median of 2 years, although the remission criteria used were strict. However, the risk of potential bias and overestimation of intervention benefits from MMF cannot be completely excluded as this is a real world and not a randomised controlled trial. © 2016 John Wiley & Sons Ltd. | en |
dc.language.iso | en | en |
dc.source | Alimentary Pharmacology and Therapeutics | en |
dc.source.uri | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84961275747&doi=10.1111%2fapt.13584&partnerID=40&md5=50519b4e9bf6cc18f40a9d54d2ccb27c | |
dc.subject | alanine aminotransferase | en |
dc.subject | aspartate aminotransferase | en |
dc.subject | azathioprine | en |
dc.subject | immunoglobulin G | en |
dc.subject | mycophenolate mofetil | en |
dc.subject | prednisolone | en |
dc.subject | azathioprine | en |
dc.subject | immunosuppressive agent | en |
dc.subject | mycophenolic acid | en |
dc.subject | prednisolone | en |
dc.subject | adolescent | en |
dc.subject | adult | en |
dc.subject | aged | en |
dc.subject | autoimmune disease | en |
dc.subject | autoimmune hepatitis | en |
dc.subject | child | en |
dc.subject | cohort analysis | en |
dc.subject | Conference Paper | en |
dc.subject | controlled study | en |
dc.subject | drug dose increase | en |
dc.subject | drug dose reduction | en |
dc.subject | drug efficacy | en |
dc.subject | drug response | en |
dc.subject | drug safety | en |
dc.subject | drug withdrawal | en |
dc.subject | female | en |
dc.subject | follow up | en |
dc.subject | gastrointestinal symptom | en |
dc.subject | herpes zoster | en |
dc.subject | human | en |
dc.subject | leukopenia | en |
dc.subject | liver cirrhosis | en |
dc.subject | major clinical study | en |
dc.subject | male | en |
dc.subject | morning dosage | en |
dc.subject | observational study | en |
dc.subject | open study | en |
dc.subject | priority journal | en |
dc.subject | prospective study | en |
dc.subject | relapse | en |
dc.subject | remission | en |
dc.subject | respiratory tract infection | en |
dc.subject | septicemia | en |
dc.subject | thrombocytopenia | en |
dc.subject | analogs and derivatives | en |
dc.subject | combination drug therapy | en |
dc.subject | complication | en |
dc.subject | Hepatitis, Autoimmune | en |
dc.subject | liver cirrhosis | en |
dc.subject | middle aged | en |
dc.subject | treatment outcome | en |
dc.subject | Adult | 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 | Immunosuppressive Agents | en |
dc.subject | Liver Cirrhosis | en |
dc.subject | Male | en |
dc.subject | Middle Aged | en |
dc.subject | Mycophenolic Acid | en |
dc.subject | Prednisolone | en |
dc.subject | Prospective Studies | en |
dc.subject | Remission Induction | en |
dc.subject | Treatment Outcome | en |
dc.subject | Blackwell Publishing Ltd | en |
dc.title | A real-world study focused on the long-term efficacy of mycophenolate mofetil as first-line treatment of autoimmune hepatitis | en |
dc.type | conferenceItem | en |
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