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Calcineurin Inhibitors in the treatment of Adult Autoimmune Hepatitis:A Systematic Review

Journal of Clinical and translational Hepatology 2022年第6期10卷 1155-1166页

作者： Martine AMC Baven-Pronk Joffre M.Hew,Jr Maaike Biewenga Maarten E.tushuizen Aad P.van den Berg Gerd Bouma johannes t.brouwer Bart van Hoek 无 Department of Gastroenterology and Hepatology Groene Hart HospitalGoudaNetherlands Department of Gastroenterolo-gy and Hepatology Leiden University Medical CenterLeidenNetherlands Department of Gastroenterology and Hepatology University Medical Center GroningenGroningenNetherlands Department of Gastroenterology and Hepatology Amsterdam University Medical Center Location VUAmsterdamNetherlands Reinier de Graaf Medical Center Delft DelftNetherlands Dutch Autoimmune Hepatitis Study Group

Background and Aims:A considerable number of au-toimmune hepatitis(AIH)patients completely or partially fail on first-line *** studies on the use of calcineurin inhibitors(CNIs)in the treatment of AIH have been published without focusing on *** aim was to assess the efficacy of CNIs in the treatment of adult AIH patients,specifically focusing on indication:first-line intolerant and with first-line insufficient response(failure to achieve or maintain remission),and with second versus third-line ***:A literature search included studies on the use of CNIs in adult *** with past or present use of CNIs from the Dutch AIH group cohort were *** primary endpoint was biochemical remission while using *** endpoints were biochemical response,treatment failure,and adverse ***:twenty studies from the literature and nine Dutch patients were included describing the use of cyclosporine in 59 and tacrolimus in 219 adult AIH *** CNI remission rate was 53%in patients with insufficient response to first-line treatment and 67%in patients intolerant to first-line *** were used as second-line treatment in 73%with a remission rate of 52%and as third-line treatment in 22%with a remission rate of 26%.Cyclosporine was discontin-ued in 13%and tacrolimus in 11%of patients because of adverse ***:CNIs as rescue treatment in adult AIH patients are reasonably effective and safe both with insufficient response or intolerance to previous *** studies are needed.

关键词： Autoimmune hepatitis Cyclosporine tacrolimus Calcineurin inhibi-tor

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