Dr. Michael P. Manns discusses his manuscript “Azathioprine With Budesonide Induces Remission More Effectively Than With Prednisone in Patients With Autoimmune Hepatitis”. To view the print version of this abstract go to
My name’s michael mann’s i’m a pathologist at the medical school of hannover hannover germany it is my pleasure to introduce today to you a new publication to be published in gastroenterology entitled food is a night induces remission more effectively than prednisone in a controlled trial of patients with autoimmune hepatitis or t1 hepatitis is a disease were loss
Of torrents against the patient’s own liver is regarded as the primary pathogenetic process this disease has first been described by valentin storm from sweden in 1951 and later dr. conklin united states has confirmed his observation and extended the investigations in autumn whenever title is showing the damona suppress the therapy is able to induce remission
And to prevent progression od whenever titus is treated for decades now were the munis oppressive regimen either steroids alone or in combination with either siren the studies that we base our guidelines on were published in the 70s and 80s meaning years before the discovery of the hepatitis c virus therefore in previous studies on the therapy what you wound up
At titus hepatitis c virus infections could not be excluded in this prospective study which is the largest prospective study ever in the treatment of autoimmune hepatitis we compared the topical steroid buddhist alight with asus i append verses prednisone in combination with ss island this study had a phase a for the first six months when the primary endpoint of
Treatment was complete remission meaning normalization of transaminases ast alt plus lack of predefined steroid specific side effects in a second phase of the study patients that were previously treated with pet nizam were switched to open label buddhist alight in order to investigate whether the switch after six months from that nizam to buddhism led to a reduction
In steroids specific side-effects the dose for buddhist tonight was three times three mini comes per day initially versus prednisone 40 milligram per day each in combination with one to two milligram of either cybron the caricom body weight the results were as follows the complete remission was achieved in the buddhist tonight arm for 47 percent of patients versus
18 percent of patients with prednisone plus at assignment meaning normalization of transaminases plus length of steroids specific side effects well we look just at biochemical remission it was 60 percent normalization of transaminases for the producer night arm versus 39 percent for the prednisone on this definition of normal transaminases is also part of the new
2010 air so the practice guidelines on autoimmune hepatitis and differs from the less than two times upper limit of normal as definition for remission in previous guidelines what is also important to note a 72 percent of pace in the buddhist on our arm did not have steer a specific sound effects versus 47 percent in the prednisone but we now look at the second part
Of the study between month six and months 12 we found that after six months 45 percent of patients in the boot prednisone arm head steer at specific side effects when we switched these patients from prednisone to paranoid this figure dropped to 26 percent meaning that the change from prednisone to buddhist anand in this perspective investigation led to a reduction
Of steroid specific side-effects so in summary buddhists aligned the topical steroid is stable in non cirrhotic patients to induce remission more efficiently than prednisone each in combination isis i burn and at the same time there were less spirit specific side effects with this topical steroid compared no professor finally when we switch from prednisone to
Buddhist on i’d the number of steroid specific side-effects was been used between months six months twelve it’s important to note that in this study non cirrhotic patients were included because in cirrhotic patients the topical benefits of buddhist aligned meaning the 90% first pass effect and therefore less steroid specific side-effects is lost due to portal
Hypertension i thank you very much for your attention
Transcribed from video
Azathioprine With Budesonide Induces Remission More Effectively Than With… By AmerGastroAssn
