Persistent normalization of serum alanine aminotransferase levels improves the prognosis of type 1 autoimmune hepatitis

Miyake, Yasuhiro; Iwasaki, Yoshiaki; Terada, Ryo; Takagi, S.; Okamaoto, Ryoichi; Ikeda, Hiroshi; Sakai, Nobuyuki; Makino, Yasuhiro; Kobashi, Haruhiko; Takaguchi, Kouichi; Sakaguchi, Kohsaku; Shiratori, Yasushi

doi:10.1016/j.jhep.2005.06.006

Cited by 88 publications

(72 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…To improve the prognosis of AIH, persistent normalization of serum transaminase levels is necessary [16,17]. In this study, none of 11 patients who achieved the normalization of serum ALT levels with UDCA monotherapy reached liver failure or developed hepatocellular carcinoma during the follow-up period.…”

Section: Discussionmentioning

confidence: 74%

Efficacy of ursodeoxycholic acid for Japanese patients with autoimmune hepatitis

et al. 2009

Self Cite

View full text Add to dashboard Cite

Purpose This study aimed to investigate the efficacy of ursodeoxycholic acid (UDCA) for Japanese patients with autoimmune hepatitis (AIH). Methods One hundred forty-seven patients were investigated. Results As initial treatment, 25 patients received UDCA (300-600 mg/day) monotherapy (UDCA group), 40 received a combination of prednisolone (PSL) (C20 mg/ day) and UDCA (combination group), 68 received PSL monotherapy (PSL group), and 14 received other treatments. During the follow-up, in the UDCA group, PSL was added to 8 of 12 patients failing to achieve the normalization of serum transaminase levels with UDCA monotherapy. Cumulative incidence of the normalization of serum transaminase levels was 64% in the UDCA group, 95% in the combination group, and 94% in the PSL group (log-rank test, P = 0.0001). UDCA group required longest periods until the normalization of serum transaminase levels. Eleven patients, who achieved persistent normalization Y. Miyake (&) Á F. Ikeda Department of Molecular Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan e-mail: miyakeyasuhiro@hotmail.com F. Ikeda e-mail: fikeda@md.okayama-u.ac.jp -009-9155-9 of serum transaminase levels with UDCA monotherapy, did not reach liver failure or develop hepatocellular carcinoma for 49.7 (range = 13.4-137.3) months. Meanwhile, during the taper of PSL, doses of PSL at the initial relapse were lower in patients treated with PSL and UDCA than in those treated with PSL monotherapy, and initial relapse occurred earlier in patients treated with PSL monotherapy. Conclusions UDCA monotherapy is effective for some Japanese AIH patients; however, UDCA monotherapy for patients with either high-grade inflammatory activity or poor residual capacity of liver function is not recommended because they may reach liver failure before achievement of remission. Meanwhile, additional use of UDCA during the taper of corticosteroids may be effective for the prevention of early relapse.123 Hepatol Int (2009) 3:556-562 DOI 10.1007/s12072

show abstract

Section: Discussionmentioning

confidence: 74%

Efficacy of ursodeoxycholic acid for Japanese patients with autoimmune hepatitis

et al. 2009

Self Cite

View full text Add to dashboard Cite

show abstract

“…Early studies found the improvement of serum aminotransferase levels to less than twice the UNL in conjunction with normalization of serum bilirubin and γ-globulin abnormalities is achievable in most patients, which can be the clinical standard for evaluating the primary treatment end point [39,40]. Researchers found complete biochemical remission on adequate immunosuppressive treatment can improve the prognosis of AIH [41].…”

Section: The Serological Targetmentioning

confidence: 99%

Treat-to-Target in Autoimmune Hepatitis: How Far To Go?

Zhang¹,

Guo²,

Wei³

et al. 2017

J AIDS Clin Res

View full text Add to dashboard Cite

“…Clinical experiences have now recognised that the rapidity 18 and completeness [259][260][261] of the response to conventional therapy are important factors in preventing or reducing hepatic fibrosis in autoimmune hepatitis. Slow responders and refractory patients have been described, 98,262 and non-invasive laboratory and radiological methods are now available to better monitor the fibrotic process.…”

Section: Management Perspectivesmentioning

confidence: 99%

Review article: the prevention and reversal of hepatic fibrosis in autoimmune hepatitis

Czaja

2014

Aliment Pharmacol Ther

View full text Add to dashboard Cite

SummaryBackgroundImmunosuppressive treatment of autoimmune hepatitis can prevent or reverse hepatic fibrosis, but these anti‐fibrotic effects are inconsistent secondary gains.AimTo describe the anti‐fibrotic effects of current therapies for autoimmune hepatitis, discuss the pathogenic mechanisms of hepatic fibrosis that might be targeted by anti‐fibrotic interventions, indicate the non‐invasive diagnostic tests of hepatic fibrosis that must be validated in autoimmune hepatitis and to suggest promising treatment opportunities.MethodsStudies cited in PubMed from 1972 to 2013 for autoimmune hepatitis, hepatic fibrosis, cirrhosis, anti‐fibrotic therapy and non‐invasive tests of hepatic fibrosis were selected.ResultsHepatic fibrosis improves in 53–57% of corticosteroid‐treated patients with autoimmune hepatitis; progressive fibrosis slows or is prevented in 79%; and cirrhosis may be reversed. Progressive hepatic fibrosis is associated with liver inflammation, and the inability to fully suppress inflammatory activity within 12 months is associated with progression to cirrhosis (54%) and death or need for liver transplantation (15%). Liver tissue examination remains the gold standard for assessing hepatic fibrosis, but laboratory and radiological tests may be useful non‐invasive methods to measure the fibrotic response. Severe liver inflammation can confound radiological assessments, and the preferred non‐invasive test in autoimmune hepatitis is uncertain. Individualised treatment adjustments and adjunctive anti‐fibrotic therapies are poised for study in this disease.ConclusionsThe prevention and reversal of hepatic fibrosis are achievable objectives in autoimmune hepatitis. Strategies that evaluate individualised therapies adjusted to the rapidity and completeness of the inflammatory response, and the use of adjunctive anti‐fibrotic interventions, must be evaluated.

show abstract

Persistent normalization of serum alanine aminotransferase levels improves the prognosis of type 1 autoimmune hepatitis

Cited by 88 publications

References 20 publications

Efficacy of ursodeoxycholic acid for Japanese patients with autoimmune hepatitis

Efficacy of ursodeoxycholic acid for Japanese patients with autoimmune hepatitis

Treat-to-Target in Autoimmune Hepatitis: How Far To Go?

Review article: the prevention and reversal of hepatic fibrosis in autoimmune hepatitis

Contact Info

Product

Resources

About