Mycophenolate mofetil treatment in patients with autoimmune hepatitis failing standard therapy with prednisolone and azathioprine
(2019) In Digestive and Liver Disease 51(2). p.253-257- Abstract
Background: Data on rescue treatment of autoimmune hepatitis in patients that fail standard treatment are sparse. Aims: To report our long-term experience with mycophenolate mofetil. Methods: Retrospective study in 22 patients with autoimmune hepatitis who failed azathioprine and prednisolone due to adverse events (n = 14, 64%), lack of remission (n = 5, 23%) or a combination (n = 3, 13%). Results: Mycophenolate mofetil was started at a dose of 20 mg/kg/day and increased to a maximum of 3 g/day. Follow-up was 0–6 months in 7 patients; more than 12 months in 15 (68%) and more than 24 months in 10. Normal aminotransferase levels were obtained (n = 3) or maintained (n = 7) in 10 patients (45%) after three to 30 weeks. 12 patients (55%)... (More)
Background: Data on rescue treatment of autoimmune hepatitis in patients that fail standard treatment are sparse. Aims: To report our long-term experience with mycophenolate mofetil. Methods: Retrospective study in 22 patients with autoimmune hepatitis who failed azathioprine and prednisolone due to adverse events (n = 14, 64%), lack of remission (n = 5, 23%) or a combination (n = 3, 13%). Results: Mycophenolate mofetil was started at a dose of 20 mg/kg/day and increased to a maximum of 3 g/day. Follow-up was 0–6 months in 7 patients; more than 12 months in 15 (68%) and more than 24 months in 10. Normal aminotransferase levels were obtained (n = 3) or maintained (n = 7) in 10 patients (45%) after three to 30 weeks. 12 patients (55%) were withdrawn during the first 6 months, due to adverse events. Three patients were switched to cyclosporine and one underwent liver transplantation. Successful treatment with mycophenolate mofetil continued in 10 patients (45%) for a median of 71 months (range 20–124). Of these, one stopped prednisolone, five have a prednisolone dose <5 mg daily and four patients 5–10 mg. Conclusion: Approximately one of two patients with autoimmune hepatitis that fail standard treatment benefit from long-term maintenance with mycophenolate mofetil, especially those with previous intolerance to thiopurines, where mycophenolate mofetil is effective in two thirds.
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- author
- Giannakopoulos, Georgios ; Verbaan, Hans LU ; Friis-Liby, Inga Lill ; Sangfelt, Per ; Nyhlin, Nils and Almer, Sven
- author collaboration
- publishing date
- 2019
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Autoimmune hepatitis, Mycophenolate mofetil, Thiopurine failure
- in
- Digestive and Liver Disease
- volume
- 51
- issue
- 2
- pages
- 253 - 257
- publisher
- Elsevier
- external identifiers
-
- pmid:30389427
- scopus:85055677387
- ISSN
- 1590-8658
- DOI
- 10.1016/j.dld.2018.10.004
- language
- English
- LU publication?
- no
- id
- ff6a3b6a-de5e-4e16-9247-fe4ce4d9f9d8
- date added to LUP
- 2018-12-07 12:29:28
- date last changed
- 2024-04-29 20:06:13
@article{ff6a3b6a-de5e-4e16-9247-fe4ce4d9f9d8,
abstract = {{<p>Background: Data on rescue treatment of autoimmune hepatitis in patients that fail standard treatment are sparse. Aims: To report our long-term experience with mycophenolate mofetil. Methods: Retrospective study in 22 patients with autoimmune hepatitis who failed azathioprine and prednisolone due to adverse events (n = 14, 64%), lack of remission (n = 5, 23%) or a combination (n = 3, 13%). Results: Mycophenolate mofetil was started at a dose of 20 mg/kg/day and increased to a maximum of 3 g/day. Follow-up was 0–6 months in 7 patients; more than 12 months in 15 (68%) and more than 24 months in 10. Normal aminotransferase levels were obtained (n = 3) or maintained (n = 7) in 10 patients (45%) after three to 30 weeks. 12 patients (55%) were withdrawn during the first 6 months, due to adverse events. Three patients were switched to cyclosporine and one underwent liver transplantation. Successful treatment with mycophenolate mofetil continued in 10 patients (45%) for a median of 71 months (range 20–124). Of these, one stopped prednisolone, five have a prednisolone dose <5 mg daily and four patients 5–10 mg. Conclusion: Approximately one of two patients with autoimmune hepatitis that fail standard treatment benefit from long-term maintenance with mycophenolate mofetil, especially those with previous intolerance to thiopurines, where mycophenolate mofetil is effective in two thirds.</p>}},
author = {{Giannakopoulos, Georgios and Verbaan, Hans and Friis-Liby, Inga Lill and Sangfelt, Per and Nyhlin, Nils and Almer, Sven}},
issn = {{1590-8658}},
keywords = {{Autoimmune hepatitis; Mycophenolate mofetil; Thiopurine failure}},
language = {{eng}},
number = {{2}},
pages = {{253--257}},
publisher = {{Elsevier}},
series = {{Digestive and Liver Disease}},
title = {{Mycophenolate mofetil treatment in patients with autoimmune hepatitis failing standard therapy with prednisolone and azathioprine}},
url = {{http://dx.doi.org/10.1016/j.dld.2018.10.004}},
doi = {{10.1016/j.dld.2018.10.004}},
volume = {{51}},
year = {{2019}},
}