| Abstract | BACKGROUND/AIM: Azathioprine is standard therapy for maintenance of remission in patients with autoimmune hepatitis. However, approximately 15% of patients are intolerant of therapy and 10% do not respond to it. There is a need for alternative therapies. We describe here the results of mycophenolate mofetil therapy in patients with autoimmune hepatitis. PATIENTS: We studied seven patients with type 1 AIH (six female). Three were intolerant of azathioprine and had elevated transaminases and liver histology showing active disease despite prednisolone therapy. Four had been on a dose of 2 mg per kg of azathioprine without complete normalisation of ALT, and had liver biopsies showing active disease. All were treated with mycophenolate 1 g bd and were followed for a median of 46 months (21-59). End points were improvement in histological inflammation, ALT and prednisolone dose. RESULTS: Five of the seven (71%) patients had normal transaminases after 3 months of treatment. The steroid dose fell from a median of 20 mg per day to 2 mg per day at 9 months (p=0.0001) and the hepatic activity index fell from median 11 to 3 (p=0.001) after 7 months of therapy. One patient required dose reduction because of a fall in white cell count. No other adverse effects were seen. CONCLUSIONS: Mycophenolate mofetil is effective and well tolerated in patients with type 1 AIH who are intolerant of, or do not respond to, azathioprine. |
| Authors | P D Richardson, P D James, S D Ryder
(Affiliation: Department of Gastroenterology, Queen's Medical Centre, University Hospital, Nottingham, UK.)
|
| Journal | Journal of hepatology
(J Hepatol)
Vol. 33
Issue 3
Pg. 371-5
(Sep 2000)
ISSN: 0168-8278 DENMARK |
| PMID | 11019991
(Publication Type: Journal Article)
|
| Chemical References |
- Anti-Inflammatory Agents
- Immunosuppressive Agents
- mycophenolate mofetil
- Mycophenolic Acid
- Azathioprine
- Prednisone
- Alanine Transaminase
|
| Topics |
- Adolescent
- Adult
- Alanine Transaminase
(blood)
- Anti-Inflammatory Agents
(administration & dosage, therapeutic use)
- Azathioprine
(adverse effects, therapeutic use)
- Dose-Response Relationship, Drug
- Drug Resistance
- Hepatitis, Autoimmune
(drug therapy, pathology)
- Humans
- Immunosuppressive Agents
(adverse effects, therapeutic use)
- Leukocyte Count
- Liver
(pathology)
- Mycophenolic Acid
(adverse effects, analogs & derivatives, therapeutic use)
- Prednisone
(administration & dosage, therapeutic use)
|
