Abstract
BackgroundMycophenolate mofetil is a commonly used salvage therapy for patients with autoimmune hepatitis (AIH).
AimTo evaluate the predictors of response to mycophenolate rescue therapy to facilitate clinical decision making.
MethodsWe performed a retrospective observational cohort study of AIH patients managed in 17 major Australian liver centres who received mycophenolate after an inadequate response or intolerance to corticosteroids with/without thiopurine(s). Baseline demographic, clinical and laboratory variables were compared between responders and nonresponders. A multivariable logistic regression model was developed using forward selection to identify independent predictors of treatment response.
ResultsA total of 105 patients received mycophenolate rescue therapy of whom 63 (60%) achieved biochemical remission. On univariable analysis, older age (P=0.003), INR
ConclusionMycophenolate remains an excellent treatment option for patients with AIH refractory to or intolerant of standard therapy with those most likely to benefit being older and/or having lower pre-treatment IgG levels.
| Original language | English |
|---|---|
| Pages (from-to) | 1314-1322 |
| Number of pages | 9 |
| Journal | Alimentary pharmacology & therapeutics |
| Volume | 49 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - May 2019 |
Cite this
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Beneficial response to mycophenolate mofetil by patients with autoimmune hepatitis who have failed standard therapy, is predicted by older age and lower immunoglobulin G and INR levels. / Gastroenterological Soc Australia.
In: Alimentary pharmacology & therapeutics, Vol. 49, No. 10, 05.2019, p. 1314-1322.Research output: Contribution to journal › Article
TY - JOUR
T1 - Beneficial response to mycophenolate mofetil by patients with autoimmune hepatitis who have failed standard therapy, is predicted by older age and lower immunoglobulin G and INR levels
AU - Gastroenterological Soc Australia
AU - Nicoll, Amanda J.
AU - Roberts, Stuart K.
AU - Lim, Ricky
AU - Mitchell, Joanne
AU - Weltman, Martin
AU - George, Jacob
AU - Wigg, Alan
AU - Stuart, Katherine
AU - Gow, Paul
AU - MacQuillan, Gerry
AU - Tse, Edmund
AU - Levy, Miriam
AU - Sood, Siddharth
AU - Zekry, Amany
AU - Cheng, Wendy
AU - Mitchell, Jonathan
AU - Skoien, Richard
AU - Sievert, William
AU - Strasser, Simone I.
AU - McCaughan, Geoffrey W.
AU - George, Jacob
AU - Gow, Paul
AU - Levy, Miriam
AU - McCaughan, Geoffrey W.
AU - Mitchell, Joanne
AU - Mitchell, Jonathan
AU - Nicoll, Amanda J.
AU - Roberts, Stuart K.
AU - Sievert, William
AU - Skoien, Richard
AU - Sood, Siddharth
AU - Strasser, Simone I.
AU - Stuart, Katherine
AU - Tse, Edmund
AU - Weltman, Martin
AU - Wigg, Alan
AU - Zekry, Amany
PY - 2019/5
Y1 - 2019/5
N2 - BackgroundMycophenolate mofetil is a commonly used salvage therapy for patients with autoimmune hepatitis (AIH).AimTo evaluate the predictors of response to mycophenolate rescue therapy to facilitate clinical decision making.MethodsWe performed a retrospective observational cohort study of AIH patients managed in 17 major Australian liver centres who received mycophenolate after an inadequate response or intolerance to corticosteroids with/without thiopurine(s). Baseline demographic, clinical and laboratory variables were compared between responders and nonresponders. A multivariable logistic regression model was developed using forward selection to identify independent predictors of treatment response.ResultsA total of 105 patients received mycophenolate rescue therapy of whom 63 (60%) achieved biochemical remission. On univariable analysis, older age (P=0.003), INRConclusionMycophenolate remains an excellent treatment option for patients with AIH refractory to or intolerant of standard therapy with those most likely to benefit being older and/or having lower pre-treatment IgG levels.
AB - BackgroundMycophenolate mofetil is a commonly used salvage therapy for patients with autoimmune hepatitis (AIH).AimTo evaluate the predictors of response to mycophenolate rescue therapy to facilitate clinical decision making.MethodsWe performed a retrospective observational cohort study of AIH patients managed in 17 major Australian liver centres who received mycophenolate after an inadequate response or intolerance to corticosteroids with/without thiopurine(s). Baseline demographic, clinical and laboratory variables were compared between responders and nonresponders. A multivariable logistic regression model was developed using forward selection to identify independent predictors of treatment response.ResultsA total of 105 patients received mycophenolate rescue therapy of whom 63 (60%) achieved biochemical remission. On univariable analysis, older age (P=0.003), INRConclusionMycophenolate remains an excellent treatment option for patients with AIH refractory to or intolerant of standard therapy with those most likely to benefit being older and/or having lower pre-treatment IgG levels.
KW - CORTICOSTEROID-THERAPY
KW - BIOCHEMICAL REMISSION
KW - NATURAL-HISTORY
KW - REAL-WORLD
KW - MANAGEMENT
KW - DIAGNOSIS
KW - CIRRHOSIS
KW - CRITERIA
KW - PATHOGENESIS
KW - POPULATION
U2 - 10.1111/apt.15248
DO - 10.1111/apt.15248
M3 - Article
VL - 49
SP - 1314
EP - 1322
JO - Alimentary pharmacology & therapeutics
JF - Alimentary pharmacology & therapeutics
SN - 0269-2813
IS - 10
ER -