Tacrolimus as an Effective and Durable Second-Line Treatment for Chronic Autoimmune Hepatitis: A Multicentric Study.

Autor: Ferre-Aracil C; Gastroenterology and Hepatology Unit, Hospital Universitario Puerta de Hierro Majadahonda, Joaquin Rodrigo 1, Majadahonda, 28888, Madrid, Spain. c_ferre_a@hotmail.com., Riveiro-Barciela M; Hepatology - Internal Medicine Unit, Hospital Universitario Vall d'Hebrón, Barcelona, Spain.; CIBERehd, Barcelona, Spain., Trapero-Marugán M; Gastroenterology and Hepatology Unit, Hospital Universitario Puerta de Hierro Majadahonda, Joaquin Rodrigo 1, Majadahonda, 28888, Madrid, Spain., Rodríguez-Perálvarez M; Hepatology and Liver Transplantation Unit, Hospital Universitario Reina Sofía, IMBIC, CIBERehd, Córdoba, Spain., Llovet LP; Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, CIBERehd, Barcelona, Spain., Téllez L; Gastroenterology and Hepatology Unit, Hospital Universitario Ramón y Cajal, IRYCIS, CIBERehd, Universidad de Alcalá, Madrid, Spain., Sánchez-Torrijos Y; UGC Aparato Digestivo, Hospital Universitario Virgen del Rocío, Seville, Spain., Díaz-Fontenla F; Gastroenterology and Hepatology Unit, Hospital Universitario Gregorio Marañón, Madrid, Spain., Salcedo-Plaza M; Gastroenterology and Hepatology Unit, Hospital Universitario Gregorio Marañón, Madrid, Spain., Álvarez-López P; Hepatology - Internal Medicine Unit, Hospital Universitario Vall d'Hebrón, Barcelona, Spain., de la Mata M; Hepatology and Liver Transplantation Unit, Hospital Universitario Reina Sofía, IMBIC, CIBERehd, Córdoba, Spain., Londoño MC; Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, CIBERehd, Barcelona, Spain., Bañares-Cañizares R; Gastroenterology and Hepatology Unit, Hospital Universitario Gregorio Marañón, Madrid, Spain., Calleja JL; Gastroenterology and Hepatology Unit, Hospital Universitario Puerta de Hierro Majadahonda, Joaquin Rodrigo 1, Majadahonda, 28888, Madrid, Spain.
Jazyk: angličtina
Zdroj: Digestive diseases and sciences [Dig Dis Sci] 2021 Aug; Vol. 66 (8), pp. 2826-2832. Date of Electronic Publication: 2020 Aug 29.
DOI: 10.1007/s10620-020-06569-9
Abstrakt: Background: Autoimmune hepatitis (AIH) is a chronic liver disease able to progress to acute liver failure, cirrhosis, and liver cancer. A significant proportion of patients fail to first-line therapy or develop severe toxicity.
Aims: To assess safety and effectiveness of tacrolimus as a second-line therapy in AIH patients.
Methods: Multicentric retrospective study of AIH patients treated with tacrolimus for at least 3 months as a second-line therapy. Effectiveness was defined as complete normalization of transaminases and IgG.
Results: A total of 23 AIH patients were included in the final analysis. In 13% of patients tacrolimus was initiated because of toxicity to previous first-line treatments and the rest were switched because of previous non-efficacy. Tacrolimus was effective in 18 patients (78%; 95%CI: 55.20-91.92%). The median time receiving tacrolimus was 16 months (IQR 20). There was a sustained response with a significant improvement in all liver enzymes and IgG on last follow-up. Only one patient discontinued tacrolimus at the third month because of severe neuropathy, and ototoxicity. Responders were significantly older at diagnosis of AIH (41 ± 13 vs. 27 ± 10 years old; p = 0.0496).
Conclusion: Tacrolimus is effective and well tolerated as a second-line therapy in patients with AIH.
(© 2020. Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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