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Baseline Predictors of the Long-Term Insufficient Biochemical Response in Patients with Autoimmune Hepatitis: A Single Center Experience

The treatment response criteria in autoimmune hepatitis (AIH) have been recently updated. This study aimed to assess treatment responses in 39 (16 males) patients with AIH confirmed by histology. Prednisone added to azathioprine or mycophenolate was the most frequent first-line treatment. Serum alan...

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Autores principales: Toniutto, Pierluigi, Zorzi, Michela, D’Alì, Lorenzo, Cussigh, Annarosa, Cmet, Sara, Bitetto, Davide, Fornasiere, Ezio, Fumolo, Elisa, Di Loreto, Carla, Falleti, Edmondo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10142659/
https://www.ncbi.nlm.nih.gov/pubmed/37109344
http://dx.doi.org/10.3390/jcm12083008
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author Toniutto, Pierluigi
Zorzi, Michela
D’Alì, Lorenzo
Cussigh, Annarosa
Cmet, Sara
Bitetto, Davide
Fornasiere, Ezio
Fumolo, Elisa
Di Loreto, Carla
Falleti, Edmondo
author_facet Toniutto, Pierluigi
Zorzi, Michela
D’Alì, Lorenzo
Cussigh, Annarosa
Cmet, Sara
Bitetto, Davide
Fornasiere, Ezio
Fumolo, Elisa
Di Loreto, Carla
Falleti, Edmondo
author_sort Toniutto, Pierluigi
collection PubMed
description The treatment response criteria in autoimmune hepatitis (AIH) have been recently updated. This study aimed to assess treatment responses in 39 (16 males) patients with AIH confirmed by histology. Prednisone added to azathioprine or mycophenolate was the most frequent first-line treatment. Serum alanine aminotransferase (ALT) levels were periodically checked for a median of 45 months. Eight (20.5%) patients presented 4 weeks non-response (NR). Baseline lower multiples of ALT above the upper normal limit (UNL) (p = 0.005), Ishak liver fibrosis score > 3 (p = 0.029), and less frequent confluent necrosis > 2 (p < 0.001) were independent predictors of NR. 24 (61.5%) patients achieved complete biochemical response (CBR) at six months. Ishak liver fibrosis score ≤ 3 (p < 0.001), lobular eosinophilic infiltrate (p < 0.001), and ≥50% decrease in serum ALT levels at week 4 (p < 0.001) were independent predictors of CBR. In addition, the GLUCRE score, derived from the multiplication of serum creatinine (mg/dL) and glucose (mg/dL) levels, were identified. A baseline GLUCRE value > 100 strongly predicted CBR failure (p = 0.003) at a follow-up greater than 12 months. In conclusion, the absence of cirrhosis and a ≥50% UNL decrease in serum ALT levels were independent predictors for CBR. A baseline GLUCRE score may help identify patients maintaining longer CBR.
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spelling pubmed-101426592023-04-29 Baseline Predictors of the Long-Term Insufficient Biochemical Response in Patients with Autoimmune Hepatitis: A Single Center Experience Toniutto, Pierluigi Zorzi, Michela D’Alì, Lorenzo Cussigh, Annarosa Cmet, Sara Bitetto, Davide Fornasiere, Ezio Fumolo, Elisa Di Loreto, Carla Falleti, Edmondo J Clin Med Article The treatment response criteria in autoimmune hepatitis (AIH) have been recently updated. This study aimed to assess treatment responses in 39 (16 males) patients with AIH confirmed by histology. Prednisone added to azathioprine or mycophenolate was the most frequent first-line treatment. Serum alanine aminotransferase (ALT) levels were periodically checked for a median of 45 months. Eight (20.5%) patients presented 4 weeks non-response (NR). Baseline lower multiples of ALT above the upper normal limit (UNL) (p = 0.005), Ishak liver fibrosis score > 3 (p = 0.029), and less frequent confluent necrosis > 2 (p < 0.001) were independent predictors of NR. 24 (61.5%) patients achieved complete biochemical response (CBR) at six months. Ishak liver fibrosis score ≤ 3 (p < 0.001), lobular eosinophilic infiltrate (p < 0.001), and ≥50% decrease in serum ALT levels at week 4 (p < 0.001) were independent predictors of CBR. In addition, the GLUCRE score, derived from the multiplication of serum creatinine (mg/dL) and glucose (mg/dL) levels, were identified. A baseline GLUCRE value > 100 strongly predicted CBR failure (p = 0.003) at a follow-up greater than 12 months. In conclusion, the absence of cirrhosis and a ≥50% UNL decrease in serum ALT levels were independent predictors for CBR. A baseline GLUCRE score may help identify patients maintaining longer CBR. MDPI 2023-04-20 /pmc/articles/PMC10142659/ /pubmed/37109344 http://dx.doi.org/10.3390/jcm12083008 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Toniutto, Pierluigi
Zorzi, Michela
D’Alì, Lorenzo
Cussigh, Annarosa
Cmet, Sara
Bitetto, Davide
Fornasiere, Ezio
Fumolo, Elisa
Di Loreto, Carla
Falleti, Edmondo
Baseline Predictors of the Long-Term Insufficient Biochemical Response in Patients with Autoimmune Hepatitis: A Single Center Experience
title Baseline Predictors of the Long-Term Insufficient Biochemical Response in Patients with Autoimmune Hepatitis: A Single Center Experience
title_full Baseline Predictors of the Long-Term Insufficient Biochemical Response in Patients with Autoimmune Hepatitis: A Single Center Experience
title_fullStr Baseline Predictors of the Long-Term Insufficient Biochemical Response in Patients with Autoimmune Hepatitis: A Single Center Experience
title_full_unstemmed Baseline Predictors of the Long-Term Insufficient Biochemical Response in Patients with Autoimmune Hepatitis: A Single Center Experience
title_short Baseline Predictors of the Long-Term Insufficient Biochemical Response in Patients with Autoimmune Hepatitis: A Single Center Experience
title_sort baseline predictors of the long-term insufficient biochemical response in patients with autoimmune hepatitis: a single center experience
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10142659/
https://www.ncbi.nlm.nih.gov/pubmed/37109344
http://dx.doi.org/10.3390/jcm12083008
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