Projects per year
Abstract
INTRODUCTION: Autoimmune hepatitis (AIH) is an immune-mediated liver disease, which requires long-term immunosuppression. Ten to fifteen percent of patients experience insufficient/intolerance response to standard therapy. Although alternate immunosuppression has been applied, there is little long-term data reported on safety, efficacy, steroid-dose reduction and disease evolution in patients with difficult AIH who were on Tacrolimus therapy.
MATERIALS AND METHODS: Clinical, biochemical, immunological profiles, treatment response and side effects of 17 AIH patients treated with Tacrolimus between 2003 and 2014 were analyzed from two tertiary referral liver centers.
RESULTS: Tacrolimus was started on 16/17 (94%) patients due to insufficient response to standard therapy. The median duration of treatment was 24 months and patients were followed up for median of 60 months. Tacrolimus dosage was 2 mg/day (median). During first year of therapy, there was a significant improvement in immunoglobulin G and Aspartate transaminase level. 9/17 (52%) compliant and definite AIH patients remained on Tacrolimus at end of follow-up and prednisolone dose reduction was achieved from 10 to 5 mg. All patients are alive and one patient underwent liver transplantation. 4/17 (24%) patients developed overlap with primary sclerosing cholangitis over follow-up period. No significant side effects were observed with Tacrolimus therapy.
CONCLUSION: Tacrolimus could be used in compliant patients with difficult to treat AIH in experienced centers. Its use is safe and can improve liver biochemistry, IgG and reduce steroid requirement. However, due to the lack of immunomodulatory effect, unmet need for effective immune-regulatory therapies still remain for AIH patients.
Original language | English |
---|---|
Pages (from-to) | 329-336 |
Number of pages | 8 |
Journal | Scandinavian Journal of Gastroenterology |
Volume | 51 |
Issue number | 3 |
Early online date | 12 Oct 2015 |
DOIs | |
Publication status | Published - Mar 2016 |
ASJC Scopus subject areas
- General Medicine
Fingerprint
Dive into the research topics of 'Long-term follow-up of patients with difficult to treat type 1 autoimmune hepatitis on Tacrolimus therapy'. Together they form a unique fingerprint.Projects
- 1 Finished
-
Intrahepatic Signals Involve in the Recruitment and Differentiation of IL-17 Secreting T Cells and Regulatory T Cells in Chronic Hepatitis - Fellowship
Oo, Y. (Principal Investigator)
4/01/12 → 5/01/18
Project: Research Councils