Patient outcomes in type 1 autoimmune hepatitis

Patients with type 1 autoimmune hepatitis (AIH) may benefit from doses of azathioprine of greater than 2mg/kg, an Australian population study has found. The authors from the Gastroenterology and Hepatology department at Canberra hospital identified 42 patients (mean age 53 years) diagnosed with the condition (prevalence of 8 per 100 000 population) within the Australian Capital Territory and the surrounding region. Overall, they found patients had a good outcome to treatment, with 86% of patients responding to initial treatment and 67% going into long term remission. One patient died from liver failure and none required liver transplantation. Azathioprine was included in the treatment regimen in 74% of cases with doses generally <2mg/kg. However, although it did not reach statistical significance, an azathioprine dose greater than or equal to 2mg/kg was associated with better clinical outcome (70% remission <2mg/kg, 83.3% remission ≥ 2mg/kg p=0.5). “Further study of the optimal use of azathioprine is warranted to determine the optimal dose,” the authors said. The study also found a non-significant association between extent of initial immune dysfunction and patient outcome, with 84% of cases with minimal elevations in their serum globulins at time of diagnosis going into long-term remission (p=0.59)....