Lack of complete biochemical response in autoimmune hepatitis leads to adverse outcome: first report of the IAIHG retrospective registry.


Journal

Hepatology (Baltimore, Md.)
ISSN: 1527-3350
Titre abrégé: Hepatology
Pays: United States
ID NLM: 8302946

Informations de publication

Date de publication:
04 Sep 2023
Historique:
received: 05 02 2023
accepted: 02 08 2023
medline: 7 9 2023
pubmed: 7 9 2023
entrez: 7 9 2023
Statut: aheadofprint

Résumé

The International Autoimmune hepatitis (AIH) Group retrospective registry (IAIHG-RR) is a web-based platform with subjects enrolled with a clinical diagnosis of AIH. As prognostic factor studies with enough power are scarce, this study aimed to ascertain data quality and identify prognostic factors in the IAIHG-RR cohort. This retrospective, observational, multicenter study included all patients with a clinical diagnosis of AIH from the IAIHG-RR. Quality assessment consisted of external validation of completeness and consistency for 29 pre-defined variables. Cox regression was used to identify risk factors for liver-related death and liver transplantation (LT). This analysis included 2559 patients across 7 countries. In 1700 patients, follow-up was available, with a completeness of individual data of 90% (range 30-100). During a median follow-up period of 10 (range 0-49) years, there were 229 deaths, of which 116 were liver-related and 143 patients underwent LT. Non-white ethnicity (HR 4.1 95% CI 2.3-7.1), cirrhosis (HR 3.5 95% CI 2.3-5.5), variant syndrome with primary sclerosing cholangitis (PSC) (HR 3.1 95% CI 1.6-6.2), and lack of complete biochemical response within 6 months (HR 5.7 95% CI 3.4-9.6) were independent prognostic factors. The IAIHG-RR represents the world's largest AIH cohort with moderate-to-good data quality and a relevant number of liver-related events. The registry is a suitable platform for patient selection in future studies. Lack of complete biochemical response to treatment, non-white ethnicity, cirrhosis and PSC-AIH were associated with liver-related death and liver transplantation.

Sections du résumé

BACKGROUND AND AIM OBJECTIVE
The International Autoimmune hepatitis (AIH) Group retrospective registry (IAIHG-RR) is a web-based platform with subjects enrolled with a clinical diagnosis of AIH. As prognostic factor studies with enough power are scarce, this study aimed to ascertain data quality and identify prognostic factors in the IAIHG-RR cohort.
METHODS METHODS
This retrospective, observational, multicenter study included all patients with a clinical diagnosis of AIH from the IAIHG-RR. Quality assessment consisted of external validation of completeness and consistency for 29 pre-defined variables. Cox regression was used to identify risk factors for liver-related death and liver transplantation (LT).
RESULTS RESULTS
This analysis included 2559 patients across 7 countries. In 1700 patients, follow-up was available, with a completeness of individual data of 90% (range 30-100). During a median follow-up period of 10 (range 0-49) years, there were 229 deaths, of which 116 were liver-related and 143 patients underwent LT. Non-white ethnicity (HR 4.1 95% CI 2.3-7.1), cirrhosis (HR 3.5 95% CI 2.3-5.5), variant syndrome with primary sclerosing cholangitis (PSC) (HR 3.1 95% CI 1.6-6.2), and lack of complete biochemical response within 6 months (HR 5.7 95% CI 3.4-9.6) were independent prognostic factors.
CONCLUSION CONCLUSIONS
The IAIHG-RR represents the world's largest AIH cohort with moderate-to-good data quality and a relevant number of liver-related events. The registry is a suitable platform for patient selection in future studies. Lack of complete biochemical response to treatment, non-white ethnicity, cirrhosis and PSC-AIH were associated with liver-related death and liver transplantation.

Identifiants

pubmed: 37676683
doi: 10.1097/HEP.0000000000000589
pii: 01515467-990000000-00557
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Investigateurs

N van Gerven (N)
K van Erpecum (K)
J den Ouden (J)
J Brouwer (J)
J Vrolijk (J)
T Gevers (T)
J Drenth (J)
M Guichelaar (M)
G Bouma (G)
T C M A Schreuder (TCMA)
E J van der Wouden (EJ)
L C Baak (LC)
R Verdonk (R)
A van der Meer (A)
M Klemt-Kropp (M)
M Verhagen (M)
A Bhalla (A)
J Kuijvenhoven (J)

Informations de copyright

Copyright © 2023 American Association for the Study of Liver Diseases.

Auteurs

Charlotte D Slooter (CD)

Department of Gastroenterology and Hepatology, Amsterdam UMC, AGEM Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Floris F van den Brand (FF)

Department of Gastroenterology and Hepatology, Amsterdam UMC, AGEM Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Ana Lleo (A)

Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Division of Internal Medicine and Hepatology, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.

Francesca Colapietro (F)

Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Division of Internal Medicine and Hepatology, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.

Marco Lenzi (M)

Department of Clinical Medicine, University of Bologna, Bologna, Italy.

Paolo Muratori (P)

Department of Sciences for the Quality of Life, University of Bologna, Bologna, Italy.

Nanda Kerkar (N)

Department of Gastroenterology, Hepatology and Nutrition, Golisano Children's Hospital, University of Rochester Medical Center, Rochester, USA.

George N Dalekos (GN)

Department of Medicine and Research Laboratory of Internal Medicine, Expertise Center of Greece in Autoimmune Liver Diseases, European Reference Network on Hepatological Diseases (ERN-RARE LIVER), General University Hospital of Larissa, Larissa, Greece.

Kalliopi Zachou (K)

Department of Medicine and Research Laboratory of Internal Medicine, Expertise Center of Greece in Autoimmune Liver Diseases, European Reference Network on Hepatological Diseases (ERN-RARE LIVER), General University Hospital of Larissa, Larissa, Greece.

M Isabel Lucena (MI)

Liver Unit, Gastroenterology Service and Department of Medicine, Vírgen de Victoria University Hospital, University of Málaga, Malaga, Spain.

Mercedes Robles-Díaz (M)

Liver Unit, Gastroenterology Service and Department of Medicine, Vírgen de Victoria University Hospital, University of Málaga, Malaga, Spain.

Daniel E Di Zeo-Sánchez (DE)

Liver Unit, Gastroenterology Service and Department of Medicine, Vírgen de Victoria University Hospital, University of Málaga, Malaga, Spain.

Raúl J Andrade (RJ)

Liver Unit, Gastroenterology Service and Department of Medicine, Vírgen de Victoria University Hospital, University of Málaga, Malaga, Spain.

Aldo J Montano-Loza (AJ)

Department of Gastroenterology and Hepatology, University of Alberta Hospital, Edmonton, Canada.

Ellina Lytvyak (E)

Department of Gastroenterology and Hepatology, University of Alberta Hospital, Edmonton, Canada.

Birgit I Lissenberg-Witte (BI)

Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.

Patrick Maisonneuve (P)

Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCCS, Milan, Italy.

Gerd Bouma (G)

Department of Gastroenterology and Hepatology, Amsterdam UMC, AGEM Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Guilherme Macedo (G)

Department of Gastroenterology and Hepatology, Centro Hospitalar São João, Porto, Portugal.

Rodrigo Liberal (R)

Department of Gastroenterology and Hepatology, Centro Hospitalar São João, Porto, Portugal.

Ynto S de Boer (YS)

Department of Gastroenterology and Hepatology, Amsterdam UMC, AGEM Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Classifications MeSH