5 recent reports on autoimmune liver disease outcomes

Recent studies on autoimmune liver diseases, such as autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis, have revealed key factors that affect treatment outcomes, recurrence rates, and risk predictors.

Healio Gastroenterology and Liver Disease presents the following reports on quality of life in patients with AIH, the effect of age on treatment response in PBC, treatment outcomes for PSC, and PBC recurrence after liver transplantation.

Age, not sex affects UDCA response in patients with PBC

Older and increasing age among patients with primary biliary cholangitis correlated with a better response to ursodeoxycholic acid treatment and lower rates of liver transplantation and mortality compared with younger age, whereas sex did not affect outcomes, according to a recently published study.

“Our data suggests that younger patients should be monitored carefully, with early consideration for additional therapies, as they appear to be at greatest risk of biochemical non-response to UDCA, liver transplantation, and death,” Angela C. Cheung, MD, from the Mayo Clinic in Rochester, Minnesota, and colleagues wrote. “The presence of more overt biochemical hepatic activity suggests a more aggressive and inflammatory phenotype in younger, compared to older patients.” Read more

PBC recurrence after liver transplantation decreases survival rates

Primary biliary cholangitis recurrence after liver transplantation reduced the likelihood for graft and overall survival, according to a recently published study.

Younger patients and those with a history of tacrolimus use and cholestasis were more likely to experience PBC recurrence posttransplant. Read more

Autoimmune hepatitis lowers quality of life regardless of remission

Patients with autoimmune hepatitis reported lower health-related quality of life compared with the general population, often related to corticosteroid use independent of remission status, according to data published in Hepatology.

Up to 50% of patients with AIH are symptomatic with fatigue, general ill health, abdominal pain, and joint pain despite treatment, according to Lin Lee Wong, MBChB, from Newcastle University in the United Kingdom, and colleagues. Read more

NGM282 safely reduces bile acid, fibrosis markers in PSC

NGM282 inhibited bile acid synthesis and decreased fibrosis markers without significantly affecting alkaline phosphatase levels among patients with primary sclerosing cholangitis, according to data published in Journal of Hepatology.

“Primary sclerosing cholangitis (PSC) is a chronic liver disease characterized by strictures of the biliary tree for which there is presently a dearth of effective medical treatment,” Gideon M. Hirschfield, MD, PhD, from the Birmingham Biomedical Research Center in the United Kingdom, and colleagues wrote. “The current trial confirms the clinical relevance of the FGF19 pathway in patients with PSC and the concept that it could be harnessed therapeutically to change the course of the disease.” Read more

Cirrhosis, PSC predict mortality risk in autoimmune hepatitis

Patients with autoimmune hepatitis without cirrhosis had a similar survival rate as the general population, whereas those with cirrhosis had increased risks for death or liver transplantation, according to recently published data.

“While some studies report that patients with [autoimmune hepatitis (AIH)] have a good prognosis and normal survival, others contradict these findings,” Floris F. van den Brand, from the Vrije Universiteit Amsterdam, and colleagues wrote. “AIH may coexist with primary biliary cholangitis (AIH-PBC) or primary sclerosing cholangitis (AIH-PSC) and recent data suggest that particularly these patients have an impaired outcome.” Read more