Cyclosporin safe, effective for long-term autoimmune hepatitis treatment
Cyclosporin (CSA) is safe and effective for long-term treatment of autoimmune hepatitis (AIH), a recent study has shown.
Researchers retrospectively assessed 20 young patients (median age at diagnosis, 9.5 years; 15 females) of whom 15 had classical AIH and five had AIH/autoimmune sclerosing cholangitis overlap syndrome. Patients were treated with CSA for a median duration of 6.3 years either alone or in combination with mycophenolate mofetil, azathioprine or prednisone.
After a median treatment period of 8.5 weeks, CSA resulted in 100-percent initial clinical and biochemical remission. After 8.6 years of follow-up, all patients were alive and had their native livers. Only one was listed for transplantation.
Of the 12 patients who received CSA as a first-line treatment, 10 reached complete remission at the end of follow-up. Four of these patients had had one or more relapse episodes. In comparison, there was one case each of treatment failure and incomplete response to treatment.
Of the eight patients who received CSA as second-line treatment, five achieved complete remission at the end of follow-up, two had treatment failure, and one had incomplete response.
In terms of safety, researchers reported hypertrichosis in 45 percent (n=9) of the participants, which resolved either spontaneously or after CSA was tapered off. Eleven patients (55 percent) displayed gingival hyperplasia, all cases of which likewise resolved after dosage reduction.
Estimated glomerular filtration rate at the beginning of CSA treatment and at the end of follow-up were statistically comparable (p=0.41), indicating the long-term safety of treatment.