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

Research output: Contribution to journalArticle

4 Citations (Scopus)

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 languageEnglish
Pages (from-to)1314-1322
Number of pages9
JournalAlimentary pharmacology & therapeutics
Volume49
Issue number10
DOIs
Publication statusPublished - May 2019

Cite this

@article{565d9e530545410f88a7225a84ba56dd,
title = "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",
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), 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.",
keywords = "CORTICOSTEROID-THERAPY, BIOCHEMICAL REMISSION, NATURAL-HISTORY, REAL-WORLD, MANAGEMENT, DIAGNOSIS, CIRRHOSIS, CRITERIA, PATHOGENESIS, POPULATION",
author = "{Gastroenterological Soc Australia} and Nicoll, {Amanda J.} and Roberts, {Stuart K.} and Ricky Lim and Joanne Mitchell and Martin Weltman and Jacob George and Alan Wigg and Katherine Stuart and Paul Gow and Gerry MacQuillan and Edmund Tse and Miriam Levy and Siddharth Sood and Amany Zekry and Wendy Cheng and Jonathan Mitchell and Richard Skoien and William Sievert and Strasser, {Simone I.} and McCaughan, {Geoffrey W.} and Jacob George and Paul Gow and Miriam Levy and McCaughan, {Geoffrey W.} and Joanne Mitchell and Jonathan Mitchell and Nicoll, {Amanda J.} and Roberts, {Stuart K.} and William Sievert and Richard Skoien and Siddharth Sood and Strasser, {Simone I.} and Katherine Stuart and Edmund Tse and Martin Weltman and Alan Wigg and Amany Zekry",
year = "2019",
month = "5",
doi = "10.1111/apt.15248",
language = "English",
volume = "49",
pages = "1314--1322",
journal = "Alimentary pharmacology & therapeutics",
issn = "0269-2813",
publisher = "Wiley-Blackwell",
number = "10",

}

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 -