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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