Paolo Muratori1, Claudine Lalanne2, Giampaolo Bianchi3, Marco Lenzi4, Luigi Muratori5. 1. Centre for the study and therapy of Autoimmune liver Disease, Bologna, Italy; Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Alma Mater Studiorum - Università di Bologna, Italy. Electronic address: paolo.muratori3@unibo.it. 2. Centre for the study and therapy of Autoimmune liver Disease, Bologna, Italy; Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Alma Mater Studiorum - Università di Bologna, Italy. Electronic address: claulal@unib.it. 3. Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Alma Mater Studiorum - Università di Bologna, Italy. Electronic address: gippob@unib.it. 4. Centre for the study and therapy of Autoimmune liver Disease, Bologna, Italy; Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Alma Mater Studiorum - Università di Bologna, Italy. Electronic address: marklenz@unib.it. 5. Centre for the study and therapy of Autoimmune liver Disease, Bologna, Italy; Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Alma Mater Studiorum - Università di Bologna, Italy. Electronic address: luimura@unib.it.
Abstract
AIM: To evaluate "ex ante" the predictive factors of incomplete/absent response to the standard therapy in a well characterized series of Autoimmune Hepatitis (AIH) patients from Italy. METHODS: Of 282 AIH patients screened from our database 166 (59%) had a sustained response and 116 (41%) had an incomplete/absent response to the therapy; all patients were analyzed for the clinical, serological and histological parameters at diagnosis. RESULTS: The patients with incomplete/absent response were characterized by significantly younger age (30 aa vs 42 aa p=0.001) and a significantly higher frequency of cirrhosis at diagnosis than patients who had a complete response to therapy (26% vs 3% p<0.0001); furthermore, patients with incomplete/absent response were distinguished from those with a complete response for significantly lower serum levels of both AST (7.9×upper normal limit [unl] vs 13×unl p<0.005) and ALT (10.9×unl vs 18×unl p=0.002) at diagnosis, and by an increase in IgG serum levels (1.43×unl vs 1.27×unl p=0.009). After stepwise logistic regression, cirrhosis at diagnosis (p=0.003, OR 0.12, 95% CI 0.03-0.49) and younger age (p=0.001, OR 1.03, 95% CI 1.01-1.05) represent two independent variables of incomplete/absent response. CONCLUSIONS: Younger age and cirrhosis are predictive of lack of response to the standard therapy in AIH patients.
AIM: To evaluate "ex ante" the predictive factors of incomplete/absent response to the standard therapy in a well characterized series of Autoimmune Hepatitis (AIH) patients from Italy. METHODS: Of 282 AIH patients screened from our database 166 (59%) had a sustained response and 116 (41%) had an incomplete/absent response to the therapy; all patients were analyzed for the clinical, serological and histological parameters at diagnosis. RESULTS: The patients with incomplete/absent response were characterized by significantly younger age (30 aa vs 42 aa p=0.001) and a significantly higher frequency of cirrhosis at diagnosis than patients who had a complete response to therapy (26% vs 3% p<0.0001); furthermore, patients with incomplete/absent response were distinguished from those with a complete response for significantly lower serum levels of both AST (7.9×upper normal limit [unl] vs 13×unl p<0.005) and ALT (10.9×unl vs 18×unl p=0.002) at diagnosis, and by an increase in IgG serum levels (1.43×unl vs 1.27×unl p=0.009). After stepwise logistic regression, cirrhosis at diagnosis (p=0.003, OR 0.12, 95% CI 0.03-0.49) and younger age (p=0.001, OR 1.03, 95% CI 1.01-1.05) represent two independent variables of incomplete/absent response. CONCLUSIONS: Younger age and cirrhosis are predictive of lack of response to the standard therapy in AIH patients.
Authors: Richard Taubert; Matthias Hardtke-Wolenski; Fatih Noyan; Claudine Lalanne; Danny Jonigk; Jerome Schlue; Till Krech; Ralf Lichtinghagen; Christine S Falk; Verena Schlaphoff; Heike Bantel; Luigi Muratori; Michael P Manns; Elmar Jaeckel Journal: PLoS One Date: 2017-06-08 Impact factor: 3.240