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001-es BibID:	BIBFORM077050
035-os BibID:	(WoS)000482217300030 (Scopus)85065040027
Első szerző:	Pape, Simon
Cím:	Predniso(lo)ne Dosage and Chance of Remission in Patients With Autoimmune Hepatitis / Simon Pape, Tom J. G. Gevers, Michail Belias, Ilyas F. Mustafajev, Jan Maarten Vrolijk, Bart van Hoek, Gerd Bouma, Carin M. J. van Nieuwkerk, Johannes Hartl, Christoph Schramm, Ansgar W. Lohse, Richard Taubert, Elmar Jaeckel, Michael P. Manns, Maria Papp, Felix Stickel, Michael A. Heneghan, Joost P. H. Drenth
Dátum:	2019
ISSN:	1542-3565 1542-7714
Megjegyzések:	BACKGROUND & 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.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk autoimmune hepatitis EASL guidelines ALT AST IgG corticosteroid induction therapy cirrhosis prednison prednisolon
Megjelenés:	Clinical Gastroenterology and Hepatology. - 17 : 10 (2019), p. 2068-2075.e2. -
További szerzők:	Gevers, Tom J. G. Belias, Michail Mustafajev, Ilyas F. Vrolijk, Jan Maarten van Hoek, Bart Bouma, Gerd van Nieuwkerk, Carin M. J. Hartl, Johannes Schramm, Christoph Lohse, Ansgar W. Taubert, Richard Jaeckel, Elmar Manns, Michael P. Papp Mária (1975-) (belgyógyász, gasztroenterológus) Stickel, Felix Heneghan, Michael A. Drenth, Joost P. H.
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