{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T13:02:04Z","timestamp":1792155724633,"version":"4.4.0"},"reference-count":45,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2016,3,16]],"date-time":"2016-03-16T00:00:00Z","timestamp":1458086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Front\u2010line therapy with mycophenolate mofetil (<jats:styled-content style=\"fixed-case\">MMF<\/jats:styled-content>) in autoimmune hepatitis (<jats:styled-content style=\"fixed-case\">AIH<\/jats:styled-content>) has shown high on\u2010treatment remission rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To study prospectively in a real\u2010world fashion the long\u2010term outcome of a large group of consecutive treatment\u2010na\u00efve <jats:styled-content style=\"fixed-case\">AIH<\/jats:styled-content> patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between 2000 and 2014, 158 patients were recruited but only 131 were eligible for treatment (109 <jats:styled-content style=\"fixed-case\">MMF<\/jats:styled-content>\/prednisolone; 22 prednisolone \u00b1 azathioprine). Long\u2010term data on outcome after drug withdrawal were evaluated. Patients stopped treatment after having achieved complete response (normal transaminases and IgG) for at least the last 2 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At diagnosis, 31.6% of patients had cirrhosis and 72.8% insidious presentation. A total of 102 of 109 (93.6%) responded initially to <jats:styled-content style=\"fixed-case\">MMF<\/jats:styled-content> within 2 (1\u201318) months. A total of 78 of 109 (71.6%) had complete response on treatment and 61 of 78 (78.2%) maintained remission off prednisolone. <jats:styled-content style=\"fixed-case\">MMF<\/jats:styled-content>\u2010treated patients had increased probability of complete response compared to those receiving azathioprine (<jats:italic>P<\/jats:italic> = 0.03). Independent predictors of complete response were lower <jats:styled-content style=\"fixed-case\">ALT<\/jats:styled-content> at 6 months (<jats:italic>P<\/jats:italic> = 0.001) and acute presentation (<jats:italic>P<\/jats:italic> = 0.03). So far, treatment withdrawal was feasible in 40\/109 patients and 30 (75%) are still in remission after 24 (2\u2013129) months. Remission maintenance was associated with longer <jats:styled-content style=\"fixed-case\">MMF<\/jats:styled-content> treatment (<jats:italic>P<\/jats:italic> = 0.005), higher baseline <jats:styled-content style=\"fixed-case\">ALT<\/jats:styled-content> (<jats:italic>P<\/jats:italic> &lt; 0.02), lower IgG on 6 months (<jats:italic>P<\/jats:italic> = 0.004) and histological improvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Mycophenolate mofetil proved to be an efficient first\u2010line treatment for <jats:styled-content style=\"fixed-case\">AIH<\/jats:styled-content>, achieving so far the highest rates of remission maintenance off treatment (75%) ever published for at least a median of 2 years, although the remission criteria used were strict. However, the risk of potential bias and overestimation of intervention benefits from <jats:styled-content style=\"fixed-case\">MMF<\/jats:styled-content> cannot be completely excluded as this is a real world and not a randomised controlled trial.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.13584","type":"journal-article","created":{"date-parts":[[2016,3,19]],"date-time":"2016-03-19T01:26:14Z","timestamp":1458350774000},"page":"1035-1047","source":"Crossref","is-referenced-by-count":100,"title":["A real\u2010world study focused on the long\u2010term efficacy of mycophenolate mofetil as first\u2010line treatment of autoimmune hepatitis"],"prefix":"10.1111","volume":"43","author":[{"given":"K.","family":"Zachou","sequence":"first","affiliation":[{"name":"Department of Medicine and Research Laboratory of Internal Medicine Medical School University of Thessaly Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. 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