| Title |
Tacrolimus and Mycophenolate Mofetil as Second-Line Therapies for Pediatric Patients with Autoimmune Hepatitis
|
|---|---|
| Published in |
Digestive Diseases and Sciences, March 2018
|
| DOI | 10.1007/s10620-018-5011-x |
| Pubmed ID | |
| Authors |
Cumali Efe, Haider Al Taii, Henriette Ytting, Niklas Aehling, Rahima A. Bhanji, Hannes Hagström, Tugrul Purnak, Luigi Muratori, Mårten Werner, Paolo Muratori, Daniel Klintman, Thomas D. Schiano, Aldo J. Montano-Loza, Thomas Berg, Fin Stolze Larsen, Naim Alkhouri, Ersan Ozaslan, Michael A. Heneghan, Eric M. Yoshida, Staffan Wahlin |
| Abstract |
We studied the efficacy and safety of mycophenolate mofetil (MMF) and tacrolimus as second-line therapy in pediatric patients with autoimmune hepatitis (AIH) who were intolerant or non-responders to standard therapy (corticosteroid and azathioprine). We performed a retrospective study of data from 13 centers in Europe, USA, and Canada. Thirty-eight patients (< 18 years old) who received second-line therapy (18 MMF and 20 tacrolimus), for a median of 72 months (range 8-182) were evaluated. Patients were categorized into two groups: Group 1 (n = 17) were intolerant to corticosteroid or azathioprine, and group 2 (n = 21) were non-responders to standard therapy. Overall complete response rates were similar in patients treated with MMF and tacrolimus (55.6 vs. 65%, p = 0.552). In group 1, MMF and tacrolimus maintained a biochemical remission in 88.9 and 87.5% of patients, respectively (p = 0.929). More patients in group 2 given tacrolimus compared to MMF had a complete response, but the difference was not statistically significant (50.0 vs. 22.2%, p = 0.195). Biochemical remission was achieved in 71.1% (27/38) of patients by tacrolimus and/or MMF. Decompensated cirrhosis was more commonly seen in MMF and/or tacrolimus non-responders than in responders (45.5 vs. 7.4%, p = 0.006). Five patients who received second-line therapy (2 MMF and 3 tacrolimus) developed side effects that led to therapy withdrawal. Long-term therapy with MMF or tacrolimus was generally well tolerated by pediatric patients with AIH. Both MMF and tacrolimus had excellent efficacy in patients intolerant to corticosteroid or azathioprine. Tacrolimus might be more effective than MMF in patients failing previous therapy. |
X Demographics
The data shown below were collected from the profiles of 5 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 3 | 60% |
| Unknown | 2 | 40% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 4 | 80% |
| Practitioners (doctors, other healthcare professionals) | 1 | 20% |
Mendeley readers
The data shown below were compiled from readership statistics for 34 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 34 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 3 | 9% |
| Student > Postgraduate | 3 | 9% |
| Professor | 3 | 9% |
| Student > Bachelor | 3 | 9% |
| Unspecified | 2 | 6% |
| Other | 6 | 18% |
| Unknown | 14 | 41% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 12 | 35% |
| Unspecified | 2 | 6% |
| Biochemistry, Genetics and Molecular Biology | 2 | 6% |
| Environmental Science | 1 | 3% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 3% |
| Other | 2 | 6% |
| Unknown | 14 | 41% |
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 April 2018.
All research outputs
#7,813,546
of 23,854,458 outputs
Outputs from Digestive Diseases and Sciences
#1,356
of 4,304 outputs
Outputs of similar age
#132,840
of 335,583 outputs
Outputs of similar age from Digestive Diseases and Sciences
#25
of 84 outputs
Altmetric has tracked 23,854,458 research outputs across all sources so far. This one has received more attention than most of these and is in the 67th percentile.
So far Altmetric has tracked 4,304 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.8. This one has gotten more attention than average, scoring higher than 68% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 335,583 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 60% of its contemporaries.
We're also able to compare this research output to 84 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 70% of its contemporaries.