Rituximab is a safe and effective alternative treatment for patients with autoimmune hepatitis: Results from the ColHai registry

Background and Aims 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...

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Published in:Liver international 2024-09, Vol.44 (9), p.2303-2314
Main Authors: Riveiro‐Barciela, Mar, Barreira‐Díaz, Ana, Esteban, Paula, Rota, Rosa, Álvarez‐Navascúes, Carmen, Pérez‐Medrano, Indhira, Mateos, Beatriz, Gómez, Elena, De‐la‐Cruz, Gema, Ferre‐Aracil, Carlos, Horta, Diana, Díaz‐González, Álvaro, Ampuero, Javier, Díaz‐Fontenla, Fernando, Salcedo, Magdalena, Ruiz‐Cobo, Juan‐Carlos, Londoño, María‐Carlota
Format: Article
Language:English
Subjects:
Anaphylaxis
anti‐CD20 monoclonal antibodies
autoimmune hepatitis
Cirrhosis
Corticoids
Corticosteroids
Disorders
Effectiveness
Hematological diseases
Hematology
Hepatitis
Indication
Liver cirrhosis
Rituximab
Steroids
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Summary:Background and Aims 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. Results 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 
ISSN:1478-3223
1478-3231
1478-3231
DOI:10.1111/liv.15970