Dr. Michael P. Manns discusses his manuscript “Azathioprine With Budesonide Induces Remission More Effectively Than With Prednisone in Patients With Autoimmune Hepatitis”.
My name is michael muns i’m a hepatologist at the medical school of hanover hanover in germany it is my pleasure to introduce today to you a new application to be published in gastroenterology entitled buddhisonite induces remission more effectively than prednisone in a controlled trial of patients with autoimmune hepatitis autoboom hepatitis is a disease where
Loss of tolerance against the patient’s own liver is regarded as the primary pathogenetic process this disease has first been described by waldenstrom from sweden in 1951 and later dr conquer in the united states has confirmed its observation and extended the investigations in autoimmune hepatitis showing that immunosuppressive therapy is able to induce remission
And to prevent progression audio hepatitis is treated for decades now with the immunosuppressive regimen either steroids alone or in combination with aether cyber 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 of ultima hepatitis
Hepatitis c virus infections could not be excluded in this prospective study which is the largest prospective study ever in the treatment of autism hepatitis we compared the topical steroid buddhisonite with acesioprine versus prednisone in combination with isocyanate 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 the second phase of the study patients that were previously treated with prednisone were switched to open-label buddhisonite in order to investigate whether the switch after six months from prepping zone to buddhisonite led to a reduction in
Steroid-specific side effects the dose for bodhisonite was three times three milligrams per day initially versus prednisone 40 milligram per day each in combination with one to two milligram of either cyber per kilogram body weight the results were as follows the complete remission was achieved in the buddhist tonight arm for 47 percent of patients versus 18 of
Patients with retinitism plus at the cyber meaning normalization of transaminases plus lack of steroid specific side effects when we look just at biochemical remission it was sixty percent normalization of transaminases for the buddhisonite arm versus thirty nine percent for the pretnesona this definition of normal transaminases is also part of the new 2010 aisld
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 is 72 percent of patients in the buddhist arm did not have steroid specific side effects versus 47 percent in the pregnancy alarm when we now look at the second part of the study
Between month 6 and month 12 we found that after six months 45 percent of patients in the bradley’s own arm had steroid-specific side effects when we switched these patients from prednisone to polysomnite this figure dropped to 26 percent meaning that the change from prednisone to medicine in this prospective investigation led to a reduction of steroid-specific
Side effects so in summary buddhisonite the topical steroid is able in non-serotic patients to induce remission more efficiently than prednisone each in combination with acer cyber and at the same time there were less steroid-specific side effects with this topical steroid compared to pregnancy finally when we switched from retinazone to buddhisonite the number
Of steroid-specific side effects was reduced between month 6 and month 12. it’s important to note that in this study non-cyrotic patients were included because in cyrotic patients the topical benefits of buddhism meaning the 90 percent 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
