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001-es BibID:BIBFORM085824
Első szerző:Pape, Simon
Cím:High discontinuation rate of azathioprine in autoimmune hepatitis, independent of time of treatment initiation / Pape Simon, Gevers Tom J. G., Vrolijk Jan Maarten, van Hoek Bart, Bouma Gerd, van Nieuwkerk Carin M. J., Taubert Richard, Jaeckel Elmar, Manns Michael P., Papp Maria, Sipeki Nora, Stickel Felix, Efe Cumali, Ozaslan Ersan, Purnak Tugrul, Nevens Frederik, Kessener Dominik J. N., Kahraman Alisan, Wedemeyer Heiner, Hartl Johannes, Schramm Christoph, Lohse Ansgar W., Heneghan Michael A., Drenth Joost P. H.
Dátum:2020
ISSN:1478-3223
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Liver International. - 40 : 9 (2020), p. 2164-2171. -
További szerzők:Gevers, Tom J. G. Vrolijk, Jan Maarten van Hoek, Bart Bouma, Gerd van Nieuwkerk, Carin M. J. Taubert, Richard Jaeckel, Elmar Manns, Michael P. Papp Mária (1975-) (belgyógyász, gasztroenterológus) Sipeki Nóra (1987-) (általános orvos) Stickel, Felix Efe, Cumali Ozaslan, Ersan Purnak, Tugrul Nevens, Frederik Kessener, Dominik J. N. Kahraman, Alisan Wedemeyer, Heiner Hartl, Johannes Schramm, Christoph Lohse, Ansgar W. Heneghan, Michael A. Drenth, Joost P. H.
Pályázati támogatás:ÚNKP-19-4
Egyéb
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2.

001-es BibID:BIBFORM081815
035-os BibID:(WoS)000552446400014 (Scopus)85084968025
Első szerző:Pape, Simon
Cím:Rapid Response to Treatment of Autoimmune Hepatitis Associated with Remission at 6 and 12 Months / Simon Pape, Tom J. G. Gevers, Jan Maarten Vrolijk, Bart van Hoek, Gerd Bouma, Carin M. J. van Nieuwkerk, Richard Taubert, Elmar Jaeckel, Michael P. Manns, Maria Papp, Nora Sipeki, Felix Stickel, Cumali Efe, Ersan Ozaslan, Tugrul Purnak, Frederik Nevens, Dominik J. N. Kessener, Alisan Kahraman, Heiner Wedemeyer, Johannes Hartl, Christoph Schramm, Ansgar W. Lohse, Joost P. H. Drenth, Michael A. Heneghan
Dátum:2020
ISSN:1542-3565 1542-7714
Megjegyzések:Background & Aims: Changes in serum levels of transaminases immediately after initiation of treatment for autoimmune hepatitis (AIH) might be associated with biochemical markers of remission and liver-related events. We assessed the outcomes of patients with vs without rapid responses to treatment of AIH in a large international cohort. Methods: We performed a retrospective cohort study, collecting data from 2 independent cohorts of adults with AIH from 12 centers in 7 countries in Europe. We collected information on patient demographics; serologic, histologic, and biochemical analyses; and treatment. We used a receiver operating characteristic curve and Youden index to calculate the optimal percentage decrease in level of aspartate aminotransferase (AST) after 8 weeks of treatment that associated with normalization of transaminase levels after 26 weeks of treatment with predniso(lo)ne (primary outcome) in the first (discovery) cohort (n = 370). We evaluated the results in the second (validation) cohort (n = 370). Secondary outcomes were liver-related death or transplantation. We performed univariate and multivariable logistic and Cox regression with correction for confounders. Results: A significant decrease in level of AST after 8 weeks of treatment was significantly associated with normalization of transaminase levels at 26 and 52 weeks ( P <.001); a decrease of more than 80% in level of AST was associated with optimal normalization. In both cohorts, rapid responders (?80% decrease in level of AST after 8 weeks) were more likely to achieve normalization of transaminases at 26 and 52 weeks when compared to non-rapid responders. Rapid responders in the discovery cohort had lower risk of liver-related death or transplantation (adjusted hazard ratio 0.18; 95% CI 0.05?0.63; P =.007), although this was not confirmed in the validation cohort. Results from measurement of alanine aminotransferase did not differ significantly from those of AST for the primary outcome. Slow responders (without normalization of transaminases after 1 year) had the highest risk of liver transplantation or liver-related death. Conclusions: In a retrospective study of patients with AIH, we found that a rapid response to treatment, based on level of AST after 8 weeks, associates with normalization of transaminase levels in the following year. Patients with a rapid response also have a lower risk of liver-related death or transplantation than patients without this rapid response.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Induction therapy,
prognostic factor,
liver enzyme,
Megjelenés:Clinical Gastroenterology and Hepatology. - 18 : 7 (2020), p. 1609-1617. -
További szerzők:Gevers, Tom J. G. Maarten Vrolijk, Jan Hoek, Bart van Bouma, Gerd Nieuwkerk, Carin M. J. van Taubert, Richard Jaeckel, Elmar Manns, Michael P. Papp Mária (1975-) (belgyógyász, gasztroenterológus) Sipeki Nóra (1987-) (általános orvos) Stickel, Felix Efe, Cumali Ozaslan, Ersan Purnak, Tugrul Nevens, Frederik Kessener, Dominik J. N. Kahraman, Alisan Wedemeyer, Heiner Hartl, Johannes Schramm, Christoph Lohse, Ansgar W. Drenth, Joost P. H. Heneghan, Michael A.
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3.

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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4.

001-es BibID:BIBFORM088130
035-os BibID:(WoS)000640696100013 (Scopus)85101877901
Első szerző:Trebica, Jonel
Cím:PREDICT identifies Precipitating Events Associated with Clinical Course of Acutely Decompensated Cirrhosis / Jonel Trebicka, Javier Fernandez, Maria Papp, Paolo Caraceni, Wim Laleman, Carmine Gambino, Ilaria Giovo, Frank Erhard Ushcner, Christian Jansen, Cesar Jimenez, Rajeshwar Mookerjee, Thierry Gustot, Agustin Albillos, Rafael Banares, Peter Jarcuska, Christian Steib, Thomas Reiberger, Juan Acevedo, Pietro Gatti, Debbie Shawcross, Stefan Zeuzem, Alexander Zipprich, Salvatore Piano, Thomas Berg, Tony Bruns, Karen V. Danielsen, Minneke Coenraad, Manuela Merli, Rudolf Stauber, Heinz Zoller, Jose Presa Ramos, Cristina Sole, German Soriano, Andrea de Gottardi, Henning Groenbaek Faouzi, Saliba Trautwein, Christian Haluk, Tarik Kani, Sven Francque, Stephen Ryder, Pierre Nahon, Manuel Romero Gomez, Hans Van Vlierberghe, Claire Francoz, Michael Manns, Elisabet Garcia, Manuel Tufoni, Alex Amoros, Marco Pavesi, Cristina Sanchez, Michael Praktiknjo, Anna Curto, Carla Pitarch, Antonella Putignano, Esau Moreno, William Bernal, Ferran Aquilar, Joan Claria, Paolo Ponzo, Zsuzsanna Vitalis, Giacomo Zaccherini, Boglarka Balogh, Alexander Gerbes, Victor Vargas, Carlo Alessandria, Mauro Bernardi, Pere Gines, Richard Moreau, Paolo Angeli, Rajiv Jalan, Vicente Arroyo
Dátum:2021
ISSN:0168-8278
Megjegyzések:ABSTRACT Introduction: Acute decompensation (AD) of cirrhosis may present without acute-onchronic liver failure (ACLF) (AD-No ACLF), or with ACLF-phenotype (AD-ACLF) defined by organ failure(s). Precipitating events may induce AD. This multicenter,prospective, observational PREDICT Study (NCT03056612) analyzes and characterizes the precipitants leading to both AD-phenotypes. Patients and Methods: The PREDICT study included 1273 non-electively hospitalized patients with AD (No-ACLF=1071; ACLF=202). Medical history, clinical and laboratory data were carefully collected at enrolment and during 90-days follow up, focused on the characteristics of precipitants, specifically induction of organ dysfunction/failure and/or systemic inflammation, chronology, intensity, and relationship to outcome in both AD phenotypes. Results: Among different clinical events, four distinct events were precipitants consistently related to AD, including proven bacterial infections, severe alcoholic hepatitis, gastrointestinal (GI) bleeding with shock and toxic encephalopathy. Among patients in the AD-No ACLF cohort and the AD-ACLF cohort with precipitants (38% and 71%, respectively), almost all (96% and 97%, respectively) showed proven bacterial infection and severe alcoholic hepatitis, either alone or in combination with other events. Interestingly, in both AD-phenotypes, proven bacterial infections and severe alcoholic hepatitis had a similar association withsurvival, and the number of precipitants was associated with significantly increased 90-day mortality, in paralleled by surrogates of systemic inflammation confirming a valid definition of precipitating events. Importantly, adequate first-line antibiotic treatment of proven bacterial infections was associated with lower ACLF development rate and higher 90-day survival. Conclusions: This study identified precipitating events that are significantly associated with a distinct clinical course and prognosis of patients with AD and specific preventive and therapeutic strategies targeting these events may improve outcome in decompensated cirrhosis.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
chronic liver disease
non-elective admission
acute complications
outcome
risk factors
Megjelenés:Journal of Hepatology. - 74 : 5 (2021), p. 1097-1108. -
További szerzők:Fernández, Javier Papp Mária (1975-) (belgyógyász, gasztroenterológus) Caraceni, Paolo Laleman, Wim Gambino, Carmine Giovo, Ilaria Uschner, Frank Erhard Jansen, Christian Jimenez, Cesar Mookerjee, Rajeshwar Gustot, Thierry Albillos, Agustin Bañares, Rafael Jarcuska, Peter Steib, Christian Reiberger, Thomas Acevedo, Juan Gatti, Pietro Shawcross, Debbie Zeuzem, Stefan Zipprich, Alexander Piano, Salvatore Berg, Thomas Bruns, Tony Danielsen, Karen V. Coenraad, Minneke Merli, Manuela Stauber Rudolf Zoller, Heinz Ramos, José Sole, Cristina Soriano, German Gottardi, Andrea De Faouzi, Henning Groenbaek Trautwein, Saliba Haluk, Christian Kani, Tarik Francque, Sven Ryder, Stephen Nahon, Pierre Gomez, Manuel Romero Vlierberghe, Hans Van Francoz, Claire Manns, Michael P. Garcia, Elisabet Tufoni, Manuel Amoros, Alex Pavesi, Marco Sánchez, Cristina Praktiknjo, Michael Curto, Anna Pitarch, Carla Putignano, Antonella Moreno, Esau Bernal, William Aquilar, Ferran Claria, Joan Ponzo, Paolo Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Zaccherini, Giacomo Balogh Boglárka (1993-) (belgyógyász) Gerbes, Alexander Vargas, Victor Alessandria, Carlo Bernardi, Mauro Ginès, Pere Moreau, Richard Angeli, Paolo Jalan, Rajiv Arroyo, Vicente
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5.

001-es BibID:BIBFORM086407
035-os BibID:(WoS)000572079900019 (Scopus)85088972261
Első szerző:Trebica, Jonel
Cím:The PREDICT study uncovers three clinical courses of acutely decompensated cirrhosis that have distinct pathophysiology / Jonel Trebicka, Javier Fernandez, Papp Mária, Paolo Caraceni, Wim Laleman, Carmine Gambino, Ilaria Giovo, Frank Erhard Uschner, Cesar Jimenez, Rajeshwar Mookerjee, Thierry Gustot, Agustin Albillos, Rafael Banares, Martin Janicko, Christian Steib, Thomas Reiberger, Juan Acevedo, Pietro Gatti, William Bernal, Stefan Zeuzem, Alexander Zipprich, Salvatore Piano, Thomas Berg, Tony Bruns, Lise Lotte Gluud, Minneke Coenraad, Manuela Merli, Rudolf Stauber, Heinz Zoller, Ana Cristino, Cristina Sole, Germán Soriano, Andrea de Gottardi, Henning Groenbaek, Faouzi Saliba, Christian Trautwein, Osman Cavit Özdogan, Francque Sven, Stephen Ryder, Pierre Nahon, Manuel Romero-Gomez, Hans Van Vlierberghe, Claire Francoz, Michael Manns, Elisabet Garcia, Manuel Tufoni, Alex Amoros, Marco Pavesi, Cristina Sanchez, Anna Curto, Carla Pitarch, Antonella Putignano, Esau Moreno, Debbie Showcross, Ferran Aguilar, Joan Claria, Paolo Ponzo, Christian Jansen, Vitális Zsuzsanna, Giacomo Zaccherini, Balogh Boglárka, Victor Vargas, Sara Montagnese, Carlo Alessandria, Mauro Bernardi, Pere Gines, Rajiv Jalan, Richard Moreau, Paolo Angeli, Vicente Arroyo
Dátum:2020
ISSN:0168-8278
Megjegyzések:Background/Aims:Acute decompensation (AD) of cirrhosis is defined by the acute development of ascites, gastrointestinal hemorrhage, hepatic encephalopathy, i nfection or any combination of these, requiring hospitalization. The presence of organ failure(s) in patients with AD defines acute-on-chronic liver failure (ACLF), while their absence defines AD. We designed the PREDICT study, a European, prospective, observational study, to characterize the clinical course of AD and predict ACLF . Methods:A total of 1071 patients with AD were enrolled to collect detailed pre-specified information on the 3-month period prior to enrollment, and clinical and laboratory data at enrollment. Patients were then closely followed-up for 3 months. The 12-month outcomes (liver transplantation, and death) were also recorded. Results:Three groups of patients were identified: Pre-ACLF patients (n=218), who developed ACLF and had 3-month and 1-year mortality rates of 53.7% and 67.4%, respectively. Unstable decompensated cirrhosis (UDC) patients (n = 233) required ?1 readmission but not developing ACLF and had 21.0% and 35.6% mortality rates. Stable decompensated cirrhosis (SDC) patients (n = 620) who were neither readmitted, nor developed ACLF and showed a 1-year mortality of only 9.5%. The 3 groups differed significantly in the grade and course of systemic inflammation (high-grade at enrollment with aggravation during follow-up in pre-ACLF; low-grade at enrollment with subsequent steady-course in UDC; and low-grade at enrollment with subsequent improvement in the SDC) and prevalence of surrogates of severe portal hypertension throughout the study (high in UDC versus low in pre-ACLF and SDC). Conclusions:Acute decompensation without ACLF is a heterogeneous condition with three different clinical courses and two major pathophysiological mechanisms: systemic inflammation and portal hypertension. Prediction of ACLF development remains a major future task.(ClinicalTrials.gov number, NCT03056612)
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Chronic liver disease
non-elective admission
acute complications
Outcome
Risk factors
Megjelenés:Journal of Hepatology. - 73 (2020), p. 842-854. -
További szerzők:Fernández, Javier Papp Mária (1975-) (belgyógyász, gasztroenterológus) Caraceni, Paolo Laleman, Wim Gambino, Carmine Giovo, Ilaria Uschner, Frank Erhard Jimenez, Cesar Mookerjee, Rajeshwar Gustot, Thierry Albillos, Agustin Bañares, Rafael Janicko, Martin Steib, Christian Reiberger, Thomas Acevedo, Juan Gatti, Pietro Bernal, William Zeuzem, Stefan Zipprich, Alexander Piano, Salvatore Berg, Thomas Bruns, Tony Gluud, Lise Lotte Coenraad, Minneke Merli, Manuela Stauber Rudolf Zoller, Heinz Cristino, Ana Sole, Cristina Soriano, German Gottardi, Andrea De Groenbaek, Henning Saliba, Faouzi Trautwein, Christian Özdogan, Osman Cavit Sven, Francque Ryder, Stephen Nahon, Pierre Romero-Gomez, Manuel Vlierberghe, Hans Van Francoz, Claire Manns, Michael P. Garcia, Elisabet Tufoni, Manuel Amoros, Alex Pavesi, Marco Sánchez, Cristina Curto, Anna Pitarch, Carla Putignano, Antonella Moreno, Esau Showcross, Debbie Aguilar, Ferran Claria, Joan Ponzo, Paolo Jansen, Christian Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Zaccherini, Giacomo Balogh Boglárka (1993-) (belgyógyász) Vargas, Victor Montagnese, Sara Alessandria, Carlo Bernardi, Mauro Ginès, Pere Jalan, Rajiv Moreau, Richard Angeli, Paolo Arroyo, Vicente
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