Tacrolimus without or with the addition of conventional immunosuppressive treatment in juvenile autoimmune hepatitis

Acta Pediatrica, 05/31/2012

Marlaka JR et al. – Tac is a promising alternative first line of treatment for autoimmune hepatitis (AIH). Although monotherapy with tacrolimus (Tac) is usually not sufficient to achieve complete remission, the prednisolone and azathioprine doses can be drastically reduced, and most of their side effects avoided.

Methods

  • Drug concentrations in blood were measured regularly and the target trough levels were 2.5-5 ng/mL. The patients were followed up for one year.
  • Their clinical, biochemical, immunological and histological status was obtained at baseline and after 1 year.

Results

  • In three cases, Tac alone led to complete remission.
  • In 14 cases, additional low doses of prednisolone or azathioprine were used for a short time in order to achieve remission.
  • In two cases, the treatment was discontinued: in one because of therapeutic failure, in another because of a suspected but unverified adverse event.
  • Ten patients reported headache and/or recurrent abdominal pain. Two patients developed inflammatory bowel disease.
  • Renal function remained intact.

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