Rituximab is a safe and effective alternative treatment for patients with autoimmune hepatitis : Results from the ColHai registry
Riveiro Barciela, Mar (Hospital Universitari Vall d'Hebron)
Barreira-Diaz, Ana (Hospital Universitari Vall d'Hebron)
Esteban, Paula (Hospital Universitari Vall d'Hebron)
Rota, Rosa (Hospital Universitari de Bellvitge)
Álvarez-Navascúes, Carmen (Hospital Universitario Central de Asturias)
Pérez Medrano, Indhira (Complejo Hospitalario Universitario de Pontevedra)
Mateos Muñoz, Beatriz (Hospital Universitario Ramón y Cajal (Madrid))
Gómez, Elena (Hospital 12 de Octubre (Madrid))
De-la-Cruz, Gema (Complejo Hospitalario Universitario de Toledo)
Ferre-Aracil, Carlos (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Horta Sangenís, Diana (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Díaz-González, Álvaro (Instituto de Investigación Sanitaria Valdecilla (Santander, Cantàbria))
Ampuero, Javier (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)
Díaz-Fontenla, Fernando (Hospital General Universitario Gregorio Marañón)
Salcedo, Magdalena (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)
Ruiz Cobo, Juan Carlos (Hospital Universitari Vall d'Hebron)
Londoño, Maria-Carlota (Hospital Clínic i Provincial de Barcelona)
Universitat Autònoma de Barcelona

Date:	2024
Abstract:	Small series suggest that rituximab could be effective as treatment for autoimmune hepatitis (AIH), although data are scarce. We aimed to evaluate the efficacy and safety of rituximab in different cohorts of patients with AIH. Methods: Multicentre retrospective analysis of the 35 patients with AIH and its variant forms treated with rituximab and included in the ColHai registry between 2015 and 2023. Most patients were female (83%), 10 (29%) had cirrhosis and four (11. 4%) variant forms of AIH. Indication for rituximab were as follows: 14(40%) refractory AIH, 19(54%) concomitant autoimmune or haematological disorder, 2(6%) intolerance to prior treatments. In three (9%) subjects with a concomitant disorder, rituximab was the first therapy for AIH. Overall, 31 (89%) patients achieved or maintained complete biochemical response (CBR), including the three in first-line therapy. No difference in CBR was observed according to rituximab indication (refractory AIH 86% vs. concomitant disorders 90%, p =. 824) or cirrhosis (80% vs. 92%, p =. 319). Rituximab was associated with a significant reduction in corticosteroids (median dose: prior 20 vs. post 5 mg, p <. 001) and the discontinuation of ≥1 immunosuppressant in 47% of patients. Flare-free rate at 1st, 2nd and 3rd year was 86%, 73% and 62% respectively. Flares were not associated with the development of liver failure and were successfully managed with repeated doses of rituximab and/or increased corticosteroids. Three (9%) patients experienced infusion-related adverse events (1 anaphylaxis and 2 flu-like symptoms) and five (14%) infections. Rituximab is safe and effective in patients with refractory AIH and those treated due to concomitant autoimmune or haematological disorders.
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Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Anti-CD20 monoclonal antibodies ; Autoimmune hepatitis ; Corticosteroids ; Liver cirrhosis ; Rituximab
Published in:	Liver international, 2024 , ISSN 1478-3231

DOI: 10.1111/liv.15970
PMID: 38809086

12 p, 1.1 MB

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