{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T22:17:21Z","timestamp":1790720241188,"version":"4.1.0"},"reference-count":27,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T00:00:00Z","timestamp":1681948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The treatment response criteria in autoimmune hepatitis (AIH) have been recently updated. This study aimed to assess treatment responses in 39 (16 males) patients with AIH confirmed by histology. Prednisone added to azathioprine or mycophenolate was the most frequent first-line treatment. Serum alanine aminotransferase (ALT) levels were periodically checked for a median of 45 months. Eight (20.5%) patients presented 4 weeks non-response (NR). Baseline lower multiples of ALT above the upper normal limit (UNL) (p = 0.005), Ishak liver fibrosis score &gt; 3 (p = 0.029), and less frequent confluent necrosis &gt; 2 (p &lt; 0.001) were independent predictors of NR. 24 (61.5%) patients achieved complete biochemical response (CBR) at six months. Ishak liver fibrosis score \u2264 3 (p &lt; 0.001), lobular eosinophilic infiltrate (p &lt; 0.001), and \u226550% decrease in serum ALT levels at week 4 (p &lt; 0.001) were independent predictors of CBR. In addition, the GLUCRE score, derived from the multiplication of serum creatinine (mg\/dL) and glucose (mg\/dL) levels, were identified. A baseline GLUCRE value &gt; 100 strongly predicted CBR failure (p = 0.003) at a follow-up greater than 12 months. In conclusion, the absence of cirrhosis and a \u226550% UNL decrease in serum ALT levels were independent predictors for CBR. A baseline GLUCRE score may help identify patients maintaining longer CBR.<\/jats:p>","DOI":"10.3390\/jcm12083008","type":"journal-article","created":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T02:05:31Z","timestamp":1682042731000},"page":"3008","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Baseline Predictors of the Long-Term Insufficient Biochemical Response in Patients with Autoimmune Hepatitis: A Single Center Experience"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2566-3041","authenticated-orcid":false,"given":"Pierluigi","family":"Toniutto","sequence":"first","affiliation":[{"name":"Hepatology and Liver Transplantation Unit, Department of Specialized Medicine, Udine University Hospital, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michela","family":"Zorzi","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Unit, Department of Specialized Medicine, Udine University Hospital, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"D\u2019Al\u00ec","sequence":"additional","affiliation":[{"name":"Department of Medicine, Institute of Pathological Anatomy, Udine University Hospital, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annarosa","family":"Cussigh","sequence":"additional","affiliation":[{"name":"Clinical Pathology, Udine University Hospital, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Cmet","sequence":"additional","affiliation":[{"name":"Clinical Pathology, Udine University Hospital, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Bitetto","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Unit, Department of Specialized Medicine, Udine University Hospital, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ezio","family":"Fornasiere","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Unit, Department of Specialized Medicine, Udine University Hospital, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Fumolo","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Unit, Department of Specialized Medicine, Udine University Hospital, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Di Loreto","sequence":"additional","affiliation":[{"name":"Department of Medicine, Institute of Pathological Anatomy, Udine University Hospital, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edmondo","family":"Falleti","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Unit, Department of Specialized Medicine, Udine University Hospital, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"18017","DOI":"10.1038\/nrdp.2018.17","article-title":"Autoimmune hepatitis","volume":"4","author":"Vergani","year":"2018","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1053\/j.gastro.2014.04.022","article-title":"Genome-wide association study identifies variants associated with autoimmune hepatitis type 1","volume":"147","author":"Zwiers","year":"2014","journal-title":"Gastroenterology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1111\/liv.15219","article-title":"Reassessement of the histological features of autoimmune hepatitis","volume":"42","author":"Zen","year":"2022","journal-title":"Liver Int."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1002\/hep.31065","article-title":"Diagnosis and Management of Autoimmune Hepatitis in Adults and Children: 2019 Practice Guidance and Guidelines from the American Association for the Study of Liver Diseases","volume":"72","author":"Mack","year":"2020","journal-title":"Hepatology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1002\/hep.22322","article-title":"Simplified criteria for the diagnosis of autoimmune hepatitis","volume":"48","author":"Hennes","year":"2008","journal-title":"Hepatology"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver (2015). EASL Clinical Practice Guidelines: Autoimmune hepatitis. J. Hepatol., 63, 971\u20131004.","DOI":"10.1016\/j.jhep.2015.06.030"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1002\/hep.1840180435","article-title":"Meeting report: International Autoimmune Hepatitis Group","volume":"18","author":"Johnson","year":"1993","journal-title":"Hepatology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2193","DOI":"10.1002\/hep.23584","article-title":"Diagnosis and management of autoimmune hepatitis","volume":"51","author":"Manns","year":"2010","journal-title":"Hepatology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1016\/j.jhep.2021.12.041","article-title":"Systematic review of response criteria and endpoints in autoimmune hepatitis by the International Autoimmune Hepatitis Group","volume":"76","author":"Pape","year":"2022","journal-title":"J. Hepatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1016\/S0168-8278(99)80297-9","article-title":"International Autoimmune Hepatitis Group Report: Review of criteria for diagnosis of autoimmune hepatitis","volume":"31","author":"Alvarez","year":"1999","journal-title":"J. Hepatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.1111\/liv.15217","article-title":"Consensus recommendations for histological criteria of autoimmune hepatitis from the International AIH Pathology Group: Results of a workshop on AIH histology hosted by the European Reference Network on Hepatological Diseases and the European Society of Pathology: Results of a workshop on AIH histology hosted by the European Reference Network on Hepatological Diseases and the European Society of Pathology","volume":"42","author":"Lohse","year":"2022","journal-title":"Liver Int."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1016\/0168-8278(95)80226-6","article-title":"Histological grading and staging of chronic hepatitis","volume":"22","author":"Ishak","year":"1995","journal-title":"J. Hepatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1989","DOI":"10.1136\/gutjnl-2020-322362","article-title":"Recent advances in clinical practice: Epidemiology of autoimmune liver diseases","volume":"70","author":"Trivedi","year":"2021","journal-title":"Gut"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e070201","DOI":"10.1136\/bmj-2022-070201","article-title":"Diagnosis and management of autoimmune hepatitis","volume":"380","author":"Muratori","year":"2023","journal-title":"BMJ"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1055\/s-0028-1109146","article-title":"Presumed cryptogenic liver disease in Germany: High prevalence of autoantibody-negative autoimmune hepatitis, low prevalence of NASH, no evidence for occult viral etiology","volume":"47","author":"Heringlake","year":"2009","journal-title":"Z. Gastroenterol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.cgh.2008.08.043","article-title":"Serologic markers do not predict histologic severity or response to treatment in patients with autoimmune hepatitis","volume":"7","author":"Mehendiratta","year":"2009","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"100601","DOI":"10.1016\/j.jhepr.2022.100601","article-title":"Long-term results of mycophenolate mofetil vs. azathioprine use in individuals with autoimmune hepatitis","volume":"4","author":"Dalekos","year":"2022","journal-title":"JHEP Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.1016\/j.jhep.2022.07.012","article-title":"Rapid response predicts complete biochemical response and histological remission in autoimmune hepatitis","volume":"77","author":"Li","year":"2022","journal-title":"J. Hepatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1016\/j.jhep.2022.06.007","article-title":"2022 International Autoimmune Hepatitis Group non-response criteria in autoimmune hepatitis: A too early endpoint?","volume":"77","author":"Medas","year":"2022","journal-title":"J. Hepatol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1111\/apt.15248","article-title":"Beneficial response to mycophenolate mofetil by patients with autoimmune hepatitis who have failed standard therapy, is predicted by older age and lower immunoglobulin G and INR levels","volume":"49","author":"Nicoll","year":"2019","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Taubert, R., Hardtke-Wolenski, M., Noyan, F., Lalanne, C., Jonigk, D., Schlue, J., Krech, T., Lichtinghagen, R., Falk, C.S., and Schlaphoff, V. (2017). Hyperferritinemia and hypergammaglobulinemia predict the treatment response to standard therapy in autoimmune hepatitis. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0179074"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"13","DOI":"10.5114\/ceh.2020.93051","article-title":"Clinical, serological, histopathological and treatment profile of autoimmune hepatitis in the elderly","volume":"6","author":"Sonthalia","year":"2020","journal-title":"Clin. Exp. Hepatol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"726128","DOI":"10.3389\/fphar.2021.726128","article-title":"Glucose Metabolism Reprogramming of Regulatory T Cells in Concanavalin A-Induced Hepatitis","volume":"12","author":"Huang","year":"2021","journal-title":"Front. Pharmacol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1111\/apt.16926","article-title":"Early predictors of corticosteroid response in acute severe autoimmune hepatitis: A nationwide multicenter study","volume":"56","author":"Llovet","year":"2022","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1016\/j.jhep.2017.11.020","article-title":"Usefulness of biochemical remission and transient elastography in monitoring disease course in autoimmune hepatitis","volume":"68","author":"Hartl","year":"2018","journal-title":"J. Hepatol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1016\/j.jhep.2014.10.018","article-title":"Patient selection based on treatment duration and liver biochemistry increases success rates after treatment withdrawal in autoimmune hepatitis","volume":"62","author":"Hartl","year":"2015","journal-title":"J. Hepatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"58","DOI":"10.3350\/cmh.2020.0189","article-title":"Recent updates on the management of autoimmune hepatitis","volume":"27","author":"Komori","year":"2021","journal-title":"Clin. Mol. Hepatol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/8\/3008\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:19:58Z","timestamp":1760123998000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/8\/3008"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,20]]},"references-count":27,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["jcm12083008"],"URL":"https:\/\/doi.org\/10.3390\/jcm12083008","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,20]]}}}