İbrahim Koral ÖNAL, Tarkan KARAKAN, Ali KARATAŞ, Mehmet CİNDORUK, Şükrü DUMLU, İbrahim DOĞAN, Mehmet İBİŞ, Mehmet ARHAN, Zeynep Gök SARGIN, Osman SÜTÇÜOĞLU, Naser Alizadeh HAGHİGHİ, Selma DEMİRBAŞ YÜCELDİ, Seren ÖZENİRLER

Otoimmün Hepatit Hastalarında Tek Merkez Tedavi Deneyimi

Amaç: Bu çalışmada otoimmun hepatit (OİH) tedavi rejimlerinin etkinliğinindeğerlendirilmesi amaçlandı.Yöntem: OİH tanısı ile takip edilen hastaların klinik, demografik verileri,aldıkları tedaviler ve tedavi yanıtları retrospektif olarak değerlendirildi.Bulgular: Çalışmaya dahil edilen 66 hastanın 61’i (%92.4) birinci basamaktedavi rejimi olarak kortikosteroid ve azatiopürin (AZA) kombinasyonualmaktaydı ve 45 hastada (%73.8) tam yanıt gözlendi. Kombinasyon tedavisialan 21 hastada (%34); tedavi yanıtsızlığı (16 hasta) ve yan etkiler (5 hasta)nedeniyle tedavi değişikliğine gidilmiş ve 10 hastada (%16) ikinci basamakrejim olarak mikofenolat mofetil (MMF) tedavisine geçilmiştir. MMF başlananhastaların 8’inde (%80) tam yanıt, 1’inde (%10) inkomplet yanıt saptanmış, 2hastada (%20) lökopeni görülmüş ancak tedaviyi kesmeyi gerektirmemiştir.Sonuç: OİH tedavisinde konvansiyonel tedavi olan AZA + kortikosteroidkombinasyonu ile hastaların yaklaşık dörtte birinde tam yanıtalınamamaktadır. Alternatif tedaviler sınırlı olmakla birlikte MMF bu konudaumut vaat edici görünmektedir.

A Single Center Treatment Experience in Autoimmune Hepatitis Patients

Aim: The aim of the study was to evaluate the efficacy of therapeutic regimens in autoimmune hepatitis (AIH). Methods: Clinical and demographical data of AIH patients including the therapeutic regimens given and the response to treatment were retrospectively evaluated. Results: Sixty-one out of 66 patients (92.4%) were treated with a combination of azathiopurine (AZA) and corticosteroids; 45 patients (73.8%) had a complete response. In 21 patients (34%) on combination therapy the treatment was modified due to nonresponse (16 patients) or side effects (5 patients) and mycophenolate mofetil (MMF) was initiated in 10 patients (16%) as a second line therapy. In MMF group; 8 patients (80%) had complete, 1 patient (10%) had incomplete response and 2 patients had leucopenia but no cessation of treatment. Conclusion: Complete response can not be obtained in approximately one fourth of patients with AZA and corticosteroid combination. Alternative treatments are limited but MMF seems to be promising in this regard.

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