There have, however, been no studies comparing the relapse rates of autoimmune hepatitis treatment regimens
There have, however, been no studies comparing the relapse rates of autoimmune hepatitis treatment regimens. complicationsincluding skin and soft tissue infections (= 0.010) and cushingoid appearance (= 0.011)than the combination group. The prednisolone group also had a higher relapse rate (odds ratio 6.13, 95% CI 1.72C21.80, = 0.005). Conclusions The absence of liver cirrhosis and hypertension at the time of diagnosis and no azathioprine exposure during the treatment period were favorable prognostic factors for complete remission. The prednisolone group had a significantly shorter median time to complete remission but higher rates of treatment complications and a higher relapse rate than the combination group. = 62)= 13)= 11)valuevalues calculated using Kruskal-Wallis Gefitinib (Iressa) test or Pearson’s chi-squared test. Abbreviations: PBC, primary biliary cholangitis; SLE, systemic lupus erythematosus; INR, international normalized ratio; TB, total bilirubin; ALT, alanine aminotransferase; AST, aspartate aminotransferase; ALP, alkaline phosphatase. Gefitinib (Iressa) Data presented as median (1st C 3rd quartile range). ?Data presented as number (percentage). The baseline characteristics and laboratory results according to the autoimmune hepatitis treatment regimens are presented in Table?2. The mean initial dose of prednisolone in the prednisolone monotherapy group was 45 15 (range, 20C60 mg), while the mean initial dose of prednisolone and azathioprine in the combination group was 20 13 (range, 10C60 mg) and 91 29 (range, 50C150 mg), respectively. There were no significant differences in age, sex, BMI, diagnostic criteria, ultra-sonographic findings, liver histopathology, the Child-Pugh scores, and the treatment endpoint between the two groups. The number of patients with primary biliary cholangitis overlap syndromes was significantly higher in the combination group, while patients with no underlying disease(s) was significantly lower. HIRS-1 Serum aspartate aminotransferase was significantly higher in the prednisolone monotherapy group. Table?2 Baseline clinical data and demographic characteristics categorized by autoimmune hepatitis treatment regimens. = 42)= 44)valuevalues calculated using Wilcoxon rank-sum test or Pearson’s chi-squared test. Abbreviations: PBC, primary biliary cholangitis; SLE, systemic lupus erythematosus; INR, international normalized ratio; TB, total bilirubin; ALT, alanine aminotransferase; AST, aspartate aminotransferase; ALP, alkaline phosphatase. Data presented as median (1st C 3rd quartile range). ?Data presented as number (percentage). The Cox-proportional hazard model revealed that the prognostic factors related to complete remission included absence of liver cirrhosis, hypertension, and azathioprine exposure, whereas age, sex, BMI, and the initial liver function test were not (Table?3). Table?3 Prognostic factors for complete remission in autoimmune hepatitis. valuevalue= 0.01). Open in a separate window Figure?2 Median time to complete remission in patients given the prednisolone monotherapy regimen and those who underwent combination regimen was 92 days (95%CI 65C264) and 336 days (95%CI 161C562), respectively, with a of 0.01. Total median time to remission was 170 days (95%CI 126C336). The prednisolone monotherapy group had higher rates of skin and soft tissue infections (= 0.01) and Cushingoid appearance (= 0.01), but there were no statistically significant differences in the rates of Gefitinib (Iressa) other side effects (cytopenia, myopathy, hyperglycemia, pneumonia, bacteremia, and urinary tract Gefitinib (Iressa) infection; Table?4). Table?4 Comparison of complication rates between two autoimmune hepatitis treatment regimens. = 42 (%)= 44 (%)value= 0.005). 4.?Discussion About 80% of the AIH patients in Srinagarind Hospital were middle-aged woman, as were patients in previous studies [2, 3]. The complete remission rate in the current study was 72.1%, which is slightly higher than that reported by Czaj et?al. . The group with an incomplete response had nearly double the negative histology for AIH as the responsive group, which may be the reason that treatment was not effective. There have not been any previous studies that have compared median time to remission between these two treatment regimens. Our study found that patients getting the prednisolone monotherapy had a significantly shorter median time to complete remission than patients getting the combination therapy. The total median time to complete remission was 170 days, which was longer than that found in a previous study ; this may be explained a higher initial dose of prednisolone leading to a shorter time to remission. A previous real-world study suggested that an initial prednisolone dose of 40 mg/day with a slower tapering protocol induced an earlier biochemical response than an initial prednisolone dose of 30 mg/day . As with previous reports, the current study confirmed that liver cirrhosis at the time of AIH diagnosis was a significant poor prognostic factor for treatment outcome [11, 13, 14, 15, 16]. We also found that absence.