TITLE

Mycophenolate mofetil for autoimmune hepatitis: a single practice experience

AUTHOR(S)
Wolf, David C.; Bojito, Lizza; Facciuto, Marcelo; Lebovics, Edward
PUB. DATE
November 2009
SOURCE
Digestive Diseases & Sciences;Nov2009, Vol. 54 Issue 11, p2519
SOURCE TYPE
Academic Journal
DOC. TYPE
journal article
ABSTRACT
Autoimmune hepatitis (AIH) is refractory to standard therapy with prednisone and azathioprine in 20% of patients. Investigators are exploring alternative immunosuppressant treatments, including mycophenolate mofetil (MMF). We assessed the outcome of MMF therapy in patients with AIH and related disorders. A retrospective analysis was performed in 16 patients with AIH, immune cholangitis, and overlap syndromes between AIH, primary biliary cirrhosis, and primary sclerosing cholangitis. MMF was used in lieu of azathioprine on account of patients' intolerance to azathioprine, disease that was refractory to prednisone plus azathioprine, or the perceived potency of MMF. With initiation of MMF, median ALT decreased from 81.5 U/l to 42.5 U/l (P = 0.03). Median prednisone dose decreased from 10 mg to 2.5 mg (P = 0.01). Prednisone was completely withdrawn in three patients. Five of 16 patients (31%) achieved biochemical remission, defined as a reduction in ALT from greater than to less than twice normal. Seven additional patients (44%) were maintained in biochemical remission. Two patients had an incomplete response to MMF and two patients experienced treatment failure. MMF was tolerated well in all but one patient, who discontinued the drug on account of paresthesias. MMF may be a safe and effective alternative to azathioprine in patients with AIH and related disorders.
ACCESSION #
44645834

 

Related Articles

  • Emerging Treatments for Autoimmune Hepatitis. A. J. Czaja // Current Drug Targets - Inflammation & Allergy;Dec2002, Vol. 1 Issue 4, p317 

    Prednisone alone or a lower dose of prednisone in combination with azathioprine induces remission and enhances survival in autoimmune hepatitis. Treatment failure, incomplete response, drug-induced side effects, and relapse after drug withdrawal are unsatisfactory outcomes that justify the...

  • Prednisone.  // Reactions Weekly;5/22/2010, Issue 1302, p38 

    The article describes a case of corticosteroid-induced mania in a 58-year-old woman with autoimmune hepatitis.

  • Methylprednisolone.  // Reactions Weekly;6/19/2010, Issue 1306, p29 

    The article describes the case of an adult woman who developed autoimmune hepatitis after receiving methylprednisolone for multiple sclerosis.

  • Clinical Features, Differential Diagnosis and Treatment of Autoimmune Hepatitis in the Elderly. Czaja, Albert J. // Drugs & Aging;2008, Vol. 25 Issue 3, p219 

    Autoimmune hepatitis affects all ages, and it is probably under-diagnosed in the elderly. Patients aged ≥60 years have a higher frequency of cirrhosis at presentation than adults aged ≤30 years, and they more commonly have HLA DRB1*04. These findings suggest that...

  • Autoimmune hepatitis type 2 associated with an unexpected and transient presence of primary biliary cirrhosis-specific antimitochondrial antibodies: a case study and review of the literature. Invernizzi, Pietro; Grazia Alessio, Maria; Smyk, Daniel S.; Lleo, Ana; Sonzogni, Aurelio; Fabris, Luca; Candusso, Manila; Bogdanos, Dimitrios P.; Iorio, Raffaele; Torre, Giuliano // BMC Gastroenterology;2012, Vol. 12 Issue 1, p92 

    Background: Unlike other autoimmune liver diseases, primary biliary cirrhosis (PBC) has never been reported in early childhood, while type 2 autoimmune hepatitis (AIH) is eminently a paediatric disease. Case presentation: We describe a case of type 2 AIH with serological positivity for...

  • Mycophenolate Mofetil as Second Line Therapy in Autoimmune Hepatitis? Hennes, Elke M.; Oo, Ye H.; Schramm, Christoph; Denzer, Ulrike; Buggisch, Peter; Wiegard, Christiane; Kanzler, Stephan; Schuchmann, Marcus; Boecher, Wulf; Galle, Peter R.; Adams, David H.; Lohse, Ansgar W. // American Journal of Gastroenterology;Dec2008, Vol. 103 Issue 12, p3063 

    INTRODUCTION: In patients with autoimmune hepatitis, efficient immunosuppressive therapy is essential to avoid progression to cirrhosis. There is no established second line therapy for patients failing standard therapy with steroids and azathioprine. The aim of this study was to examine the...

  • Autoimmune Hepatitis in the Elderly. Schramm, Christoph; Kanzler, Stephan; Zum Büschenfelde, Karl-Hermann Meyer; Galle, Peter R.; Lohse, Ansgar W. // American Journal of Gastroenterology;May2001, Vol. 96 Issue 5, p1587 

    OBJECTIVES: Autoimmune hepatitis (AIH) is widely believed to be a disease of young women and menopause. Little is known about the frequency and clinical characteristics in patients aged ≥ 65 yr. METHODS: We reviewed charts of 120 consecutive outpatients with known AIH to identify patients...

  • Ciclosporin.  // Reactions Weekly;7/22/2006, Issue 1111, p9 

    The article presents several case studies of one female and four male heart transplant patients who developed biopsy-proven ciclosporin nephrotoxicity while undergoing immunosuppressive therapy with ciclosporin, azathioprine, and prednisone.

  • Deflazacort/prednisone.  // Reactions Weekly;May2015, Vol. 1553 Issue 1, p115 

    The article presents a case study of a boy who developed stunted growth while receiving deflazacort and prednisone.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics