Digestive diseases and sciences · 2020
Tacrolimus as an Effective and Durable Second-Line Treatment for Chronic Autoimmune Hepatitis: A Multicentric Study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Ferre-Aracil Carlos, Riveiro-Barciela Mar, Trapero-Marugán María, Rodríguez-Perálvarez Manuel, Llovet Laura-Patricia, Téllez Luis, Sánchez-Torrijos Yolanda, Díaz-Fontenla Fernando, Salcedo-Plaza Magdalena, Álvarez-López Patricia, de la Mata Manuel, Londoño María-Carlota, Bañares-Cañizares Rafael, Calleja José Luis
Аннотация
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.
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.