Safety issues in the management of autoimmune hepatitis.

Safety issues in the management of autoimmune hepatitis. Research Abstract Details 

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Safety issues in the management of autoimmune hepatitis. Abstract Text:

BACKGROUND: Prednisone and azathioprine are effective in the treatment of autoimmune hepatitis, but diverse side effects can diminish their net benefit. OBJECTIVES: Describe the frequency and nature of these side effects and propose management strategies to minimize their impact. METHODS: Pertinent articles published from 1970 to 2007 were identified by Medline search and through a personal library. RESULTS: Medication is prematurely discontinued in 13% of patients mainly because of cosmetic changes, cytopenia, or osteopenia. Populations at high risk are the elderly, those with pre-existent co-morbidities, patients with near-zero thiopurine methyltransferase activity, individuals who are treatment-dependent, pregnant women, and asymptomatic patients who are over-treated. CONCLUSIONS: Proper patient selection, effective pre-treatment counseling, preemptive protective measures, realistic treatment objectives, and early identification of problematic patients can reduce complications. Individualized dosing schedules and the emergence of non-steroidal medications are realistic expectations.

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PUBLICATION TYPE: Journal Article

Journal: Expert opinion on drug safety

VOLUME: 7

Page Numbers: 319-33

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ISSN: 1744-764X

DAY: 8

MONTH: May

YEAR: 2008

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LANGUAGE: eng

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AFFILIATION: Mayo Clinic and Mayo Clinic College of Medicine, Division of Gastroenterology and Hepatology, Department of Medicine, 200 First Street SW, Rochester, Minnesota 55905, USA. czaja.albert@mayo.edu

Country: England

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MEDLINETA: Expert Opin Drug Saf

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