Predniso(lo)ne Dosage and Chance of Remission in Patients With Autoimmune Hepatitis

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dc.contributor.authorPape, Simon
dc.contributor.authorGevers, Tom J.G.
dc.contributor.authorBelias, Michail
dc.contributor.authorMustafajev, Ilyas F.
dc.contributor.authorVrolijk, Jan Maarten
dc.contributor.authorvan Hoek, Bart
dc.contributor.authorBouma, Gerd
dc.contributor.authorvan Nieuwkerk, Carin M.J.
dc.contributor.authorHartl, Johannes
dc.contributor.authorSchramm, Christoph
dc.contributor.authorLohse, Ansgar W.
dc.contributor.authorTaubert, Richard
dc.contributor.authorJaeckel, Elmar
dc.contributor.authorManns, Michael P.
dc.contributor.authorPapp, Maria
dc.contributor.authorStickel, Felix
dc.contributor.authorHeneghan, Michael A.
dc.contributor.authorDrenth, Joost P.H.
dc.contributor.authorDinya Tamás Ákosné Dr.Papp Mária (1975-) (belgyógyász, gasztroenterológus)
dc.contributor.submitterdepBelgyógyászati Intézet -- 84
dc.contributor.submitterdepGastroenterológiai Nem Önálló Tanszék -- 55
dc.contributor.submitterdepÁOK
dc.contributor.submitterdepDebreceni Egyetem
dc.date.accessioned2019-02-11T21:38:22Z
dc.date.available2019-02-11T21:38:22Z
dc.date.oa2019-09-16
dc.date.updated2019-02-11T21:38:22Z
dc.description.abstractBACKGROUND & AIMS: Patients with autoimmune hepatitis (AIH) commonly receive induction therapy with predniso(lo)ne followed by maintenance therapy with azathioprine. European Association for Study of the Liver clinical practice guidelines advise a predniso(lo)ne dose range of 0.50-1 mg/kg/day, which leaves room for practice variation. We performed a multicenter study to determine the efficacy of different dose ranges of predniso(lo)ne induction therapy in a large European cohort of patients with AIH. METHODS: We performed a retrospective cohort study using a comparative effectiveness design. We collected data from 451 adults with AIH who began treatment from 1978 through 2017 at 9 centers in 5 European countries. We assigned patients to a high-dose group (initial predniso(lo)ne dose ≥0.50 mg/kg/day; n=281) or a low-dose group (<0.50 mg/kg/day; n=170). Logistic regression was performed to determine difference in outcomes between the groups. The primary outcome was normal serum levels of transaminases at 6 months after initiation of therapy. RESULTS: There was no significant difference in rates of normalization of transaminases between the high-dose predniso(lo)ne group and the low-dose group (70.5% vs 64.7%; P=.20). After multivariable logistic regression with correction for confounders, there was no difference in the likelihood of normalization of transaminases between the groups (odds ratio, 1.21; 95% CI, 0.78 - 1.87; P=.38). Patients given an initial high dose of predniso(lo)ne received more predniso(lo)ne over time than patients started on a lower dose (median doses over 6 months: 3780 mg vs 2573 mg) (P<.01). CONCLUSIONS: In a retrospective study of patients with AIH in Europe, we found that the dose of predniso(lo)ne to induce remission in patients with AIH is less relevant than assumed. An initial predniso(lo)ne dose below 0.50 mg/kg/day substantially decreases unnecessary exposure to predniso(lo)ne in patients with AIH.
dc.description.correctorLB
dc.identifier.citationClinical Gastroenterology and Hepatology. -"Accepted by Publisher" : - (2019), p. -. -Clin. Gastroenterol. Hepatol. -1542-3565. -1542-7714
dc.identifier.doi10.1016/j.cgh.2018.12.035
dc.identifier.issn1542-3565. -
dc.identifier.issn1542-7714
dc.identifier.opachttp://webpac.lib.unideb.hu:8082/ebib/CorvinaWeb?action=cclfind&resultview=long&ccltext=idno+BIBFORM077048
dc.identifier.urihttp://hdl.handle.net/2437/263679
dc.identifier.urlhttps://linkinghub.elsevier.com/retrieve/pii/S1542356519300084
dc.languageeng
dc.rights.accessopen access pre-print és post-print
dc.rights.embargo12
dc.rights.ownerElsevier
dc.subject.otheridegen nyelvű folyóiratközlemény külföldi lapban
dc.subject.otherautoimmune hepatitis
dc.subject.otherEASL guidelines
dc.subject.otherALT
dc.subject.otherAST
dc.subject.otherIgG
dc.subject.othercorticosteroid
dc.subject.otherinduction therapy
dc.subject.othercirrhosis
dc.subject.otherprednison
dc.subject.otherprednisolon
dc.titlePredniso(lo)ne Dosage and Chance of Remission in Patients With Autoimmune Hepatitis
dc.typefolyóiratcikk
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