Infliximab as a rescue treatment in difficult-to-treat autoimmune hepatitis.
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Infliximab as a rescue treatment in difficult-to-treat autoimmune hepatitis. / Weiler-Normann, Christina; Schramm, Christoph; Quaas, Alexander; Wiegard, Christiane; Glaubke, Claudia; Pannicke, Nadine; Hübener, Sina; Lohse, Ansgar W.
In: J HEPATOL, Vol. 58, No. 3, 3, 2013, p. 529-534.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Infliximab as a rescue treatment in difficult-to-treat autoimmune hepatitis.
AU - Weiler-Normann, Christina
AU - Schramm, Christoph
AU - Quaas, Alexander
AU - Wiegard, Christiane
AU - Glaubke, Claudia
AU - Pannicke, Nadine
AU - Hübener, Sina
AU - Lohse, Ansgar W
N1 - Copyright © 2012 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
PY - 2013
Y1 - 2013
N2 - BACKGROUND & AIMS: Autoimmune hepatitis is a chronic inflammatory liver disease that leads to liver cirrhosis and corresponding complications, if left untreated. Current standard treatment with azathioprine and prednisolone induces remission in the vast majority of patients. However, for those patients not responding to standard treatment or not tolerating these drugs, few alternatives can be used and their effectiveness might be limited. We sought to analyze the safety and efficacy of off-label treatment with infliximab in a cohort of eleven patients with difficult-to-treat autoimmune hepatitis.METHODS: Patients with difficult-to-treat autoimmune hepatitis who could not be brought into remission with standard treatment, either due to drug intolerance or to insufficient drug impact, were treated off-label with infliximab for a minimum of six months. Patient files were reviewed retrospectively.RESULTS: Treatment with infliximab led to reduction of inflammation, evidenced by a decrease in transaminases (mean AST prior treatment 475 U/L ± 466, mean AST during treatment 43 U/L ± 32) as well as in immunoglobulins (pretreatment mean IgG 24.8 mg/dl ± 10.1, mean IgG during treatment 17.38 mg/dl ± 6). Infectious complications occurred in seven out of eleven patients and close monitoring was necessary.CONCLUSIONS: Infliximab may be considered as rescue therapy in patients with difficult-to-treat autoimmune hepatitis, albeit treatment may be associated with infectious complications.
AB - BACKGROUND & AIMS: Autoimmune hepatitis is a chronic inflammatory liver disease that leads to liver cirrhosis and corresponding complications, if left untreated. Current standard treatment with azathioprine and prednisolone induces remission in the vast majority of patients. However, for those patients not responding to standard treatment or not tolerating these drugs, few alternatives can be used and their effectiveness might be limited. We sought to analyze the safety and efficacy of off-label treatment with infliximab in a cohort of eleven patients with difficult-to-treat autoimmune hepatitis.METHODS: Patients with difficult-to-treat autoimmune hepatitis who could not be brought into remission with standard treatment, either due to drug intolerance or to insufficient drug impact, were treated off-label with infliximab for a minimum of six months. Patient files were reviewed retrospectively.RESULTS: Treatment with infliximab led to reduction of inflammation, evidenced by a decrease in transaminases (mean AST prior treatment 475 U/L ± 466, mean AST during treatment 43 U/L ± 32) as well as in immunoglobulins (pretreatment mean IgG 24.8 mg/dl ± 10.1, mean IgG during treatment 17.38 mg/dl ± 6). Infectious complications occurred in seven out of eleven patients and close monitoring was necessary.CONCLUSIONS: Infliximab may be considered as rescue therapy in patients with difficult-to-treat autoimmune hepatitis, albeit treatment may be associated with infectious complications.
KW - Adult
KW - Aged
KW - Alanine Transaminase
KW - Antibodies, Monoclonal
KW - Female
KW - Hepatitis, Autoimmune
KW - Humans
KW - Immunoglobulin G
KW - Male
KW - Middle Aged
KW - Retrospective Studies
KW - Tumor Necrosis Factor-alpha
U2 - 10.1016/j.jhep.2012.11.010
DO - 10.1016/j.jhep.2012.11.010
M3 - SCORING: Journal article
C2 - 23178709
VL - 58
SP - 529
EP - 534
JO - J HEPATOL
JF - J HEPATOL
SN - 0168-8278
IS - 3
M1 - 3
ER -