Mycophenolate mofetil for the treatment of autoimmune hepatitis in patients refractory or intolerant to conventional therapy

Kaveh Sharzehi, Mary Ann Huang, Ian R. Schreibman, Kimberly A. Brown

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

BACKGROUND: Autoimmune hepatitis is characterized by hepatocellular inflammation often progressing to cirrhosis. Standard treatment consists of corticosteroids and azathioprine. For the 20% of patients with refractory disease or those who are intolerant to medication, there is no standardized treatment. OBJECTIVE: To evaluate mycophenolate mofetil (MMF) as an alternative therapy for autoimmune hepatitis. METHODS: The present retrospective study identified all patients with autoimmune hepatitis who were treated with MMF over a 10-year period at the Henry Ford Hospital (Michigan, USA). These patients were evaluated for tolerance and response. RESULTS: Of the 90 patients participating in the study, 48% had a complete response, 32% experienced relapses and 21% were refractory. MMF was initiated in 21 patients - 12 (57%) for refractory disease and nine (43%) for medication intolerance. Of the 12 patients converted for refractory disease, all showed biochemical improvement but none had a complete response. Of the patients converted due to intolerance, 88% maintained complete remission. For all patients converted to MMF, there was a mean decrease in steroid dose from 18.9 mg/day to 7.8 mg/day (P=0.01). CONCLUSION: In patients with autoimmune hepatitis who were intolerant to conventional therapy, MMF was well tolerated, with 88% of patients maintained in remission. MMF did not induce remission in those refractory to conventional therapy; however, it resulted in a significant decrease in steroid use. Prospective studies are needed to better assess the role of MMF as an alternative therapy.

Original languageEnglish (US)
Pages (from-to)588-592
Number of pages5
JournalCanadian Journal of Gastroenterology
Volume24
Issue number10
DOIs
StatePublished - Jan 1 2010
Externally publishedYes

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Mycophenolic Acid
Autoimmune Hepatitis
Therapeutics
Complementary Therapies
Steroids
Azathioprine
Adrenal Cortex Hormones
Fibrosis
Retrospective Studies
Prospective Studies

Keywords

  • Autoimmune liver disease
  • Difficult to treat
  • Mycophenolate

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Mycophenolate mofetil for the treatment of autoimmune hepatitis in patients refractory or intolerant to conventional therapy. / Sharzehi, Kaveh; Huang, Mary Ann; Schreibman, Ian R.; Brown, Kimberly A.

In: Canadian Journal of Gastroenterology, Vol. 24, No. 10, 01.01.2010, p. 588-592.

Research output: Contribution to journalArticle

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