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Biochemical efficacy of tioguanine in autoimmune hepatitis: a retrospective review of practice in the Netherlands.
- Source :
-
Alimentary Pharmacology & Therapeutics . Oct2018, Vol. 48 Issue 7, p761-767. 7p. 4 Charts, 4 Graphs. - Publication Year :
- 2018
-
Abstract
- Summary: Background: Azathioprine (AZA) and mercaptopurine (MP) are the cornerstone of steroid‐sparing strategies in autoimmune hepatitis (AIH). Up to 20% of patients do not tolerate or respond to these regimens. Aim: To evaluate retrospectively the tolerability and efficacy of tioguanine (thioguanine) (TG) therapy in selected patients with AIH and AIH variant syndromes. Methods: Records of 52 patients who received TG therapy were retrieved from nine hospitals in the Netherlands. Indications for TG treatment were intolerable side effects on AZA or MP (n = 38), insufficient response (n = 11) or first‐line treatment (n = 3). Treatment efficacy was defined as normalisation of serum aminotransferases and serum immunoglobulin G. Results: No serious adverse events occurred in patients treated with TG during a median follow‐up of 18 months (range 1‐194). Treatment was well tolerated in 41 patients (79%), whereas four had tolerable (8%) and seven (13%) intolerable side effects. Thirty‐eight patients were treated with TG after intolerable side effects on AZA or MP; 29 patients continued TG therapy of whom 24 (83%) achieved complete biochemical remission, four (14%) had incomplete and one (3%) had no response; nine discontinued treatment. Seven of 11 patients with insufficient response to AZA or MP were responsive to TG, three with complete and four with incomplete biochemical remission; four discontinued due to intolerance (n = 2) and non‐response (n = 2). TG was effective in all AIH patients as first‐line maintenance treatment. Conclusion: In our retrospective review of TG therapy in selected patients with AIH or AIH variants who previously failed on AZA or MP, TG appeared tolerable with biochemical efficacy. [ABSTRACT FROM AUTHOR]
- Subjects :
- *CHRONIC active hepatitis
*AZATHIOPRINE
*IMMUNOGLOBULIN G
*AMINOTRANSFERASES
Subjects
Details
- Language :
- English
- ISSN :
- 02692813
- Volume :
- 48
- Issue :
- 7
- Database :
- Academic Search Index
- Journal :
- Alimentary Pharmacology & Therapeutics
- Publication Type :
- Academic Journal
- Accession number :
- 131928239
- Full Text :
- https://doi.org/10.1111/apt.14939