Original articlePancreas, biliary tract, and liverEfficacy and Safety of Mycophenolate Mofetil in Patients With Autoimmune Hepatitis and Suboptimal Outcomes After Standard Therapy
Section snippets
Study Design
This was a multicenter, retrospective study of cases of AIH managed across 17 metropolitan and regional liver centers affiliated with the ALA CRN. Medical records of AIH subjects who fulfilled eligibility criteria were identified from multiple hospital resources including pharmacy prescription databases, health information services, electronic medical records, and existing liver clinic databases. Data recorded in the patients’ medical records during clinic visits were transcribed onto a
Study Population
One hundred nine patients with an established diagnosis of AIH and treatment with MMF were identified. Of these, 4 were excluded for the efficacy analysis because of follow-up <1 month (n = 3) and concomitant hepatitis C infection (n = 1), leaving a final cohort of 105 patients. The baseline characteristics of this cohort are shown in Table 1. As expected, the cohort predominantly involved white women, with the vast majority (97%) having type 1 AIH and the mean age being 50 years at diagnosis
Discussion
To our knowledge this is the largest study evaluating the efficacy and safety of MMF as rescue therapy in adult patients with AIH who are refractory and/or intolerant to therapy with corticosteroids with or without thiopurine(s). Using the resources of the ALA CRN, we identified 105 patients across 17 sites who met protocol-specified criteria for study inclusion, of whom around 40% had cirrhosis. The main findings of the study were that treatment with MMF appeared well-tolerated in patients and
References (35)
- et al.
Autoimmune hepatitis in Denmark: incidence, prevalence, prognosis, and causes of death—a nationwide registry-based cohort study
J Hepatol
(2014) - et al.
Prognosis of histologic cirrhosis in type 1 autoimmune hepatitis
Gastroenterology
(1996) - et al.
Long term outcomes of patients with autoimmune hepatitis managed at a nontransplant centre
Gastroenterology
(2011) - et al.
Budesonide induces remission more effectively than prednisone in a controlled trial of patients with autoimmune hepatitis
Gastroenterology
(2010) - et al.
Mycophenolate mofetil for maintenance of remission in autoimmune hepatitis in patients resistant to or intolerant of azathioprine
J Hepatol
(2000) - et al.
Histological changes after the use of mycophenolate mofetil in autoimmune hepatitis
Hum Pathol
(2004) - et al.
Mycophenolate mofetil in autoimmune hepatitis patients not responsive or intolerant to standard immunosuppressive therapy
Clin Gastroenterol Hepatol
(2007) - et al.
A single center review of the use of mycophenolate mofetil in the treatment of autoimmune hepatitis
Clin Gastroenterol Hepatol
(2008) - et al.
Mycophenolate mofetil as rescue treatment for autoimmune liver disease in children: a 5-year follow-up
J Hepatol
(2009) - et al.
Diagnosis and treatment of autoimmune hepatitis
Hepatology
(2002)
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
J Hepatol
Autoimmune hepatitis
N Engl J Med
Epidemiology and the initial presentation of autoimmune hepatitis in Sweden: a nationwide study
Scand J Gastroenterol
Advances in the diagnosis, pathogenesis, and management of autoimmune hepatitis
Gastroenterology
Autoimmune hepatitis in southern Israel: a 15-year multicentre study
J Dig Dis
Diagnosis and management of autoimmune hepatitis
Hepatology
Systematic review: managing suboptimal treatment responses in autoimmune hepatitis with conventional and nonstandard drugs
Aliment Pharmacol Ther
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Conflicts of interest The authors disclose no conflicts.