2026-04-05T12:38:30Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/119782025-10-24T10:28:41Zcom_2072_378070com_2072_378040col_2072_378092

Rituximab is a safe and effective alternative treatment for patients with autoimmune hepatitis: Results from the ColHai registry Esteban, Paula Rota, Rosa Álvarez-Navascúes, Carmen Perez Medrano, Indhira Riveiro-Barciela, Mar Barreira, Ana Ruiz Cobo, Juan Carlos Avaluació de resultats (Assistència sanitària) Hepatitis - Tractament Anticossos monoclonals - Ús terapèutic Hepatitis - Aspectes immunològics DISEASES::Digestive System Diseases::Liver Diseases::Hepatitis::Hepatitis, Chronic::Hepatitis, Autoimmune Other subheadings::Other subheadings::Other subheadings::/drug therapy CHEMICALS AND DRUGS::Amino Acids, Peptides, and Proteins::Proteins::Blood Proteins::Immunoproteins::Immunoglobulins::Antibodies::Antibodies, Monoclonal Other subheadings::Other subheadings::/therapeutic use ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome ENFERMEDADES::enfermedades del sistema digestivo::enfermedades hepáticas::hepatitis::hepatitis crónica::hepatitis autoinmune Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia COMPUESTOS QUÍMICOS Y DROGAS::aminoácidos, péptidos y proteínas::proteínas::proteínas sanguíneas::inmunoproteínas::inmunoglobulinas::anticuerpos::anticuerpos monoclonales Otros calificadores::Otros calificadores::/uso terapéutico TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento Anti‐CD20 monoclonal antibodies; Autoimmune hepatitis; Corticosteroids Anticuerpos monoclonales anti‐CD20; Hepatitis autoinmune; Corticosteroides Anticossos monoclonals anti-CD20; Hepatitis autoimmune; Corticoides 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 < .001) and the discontinuation of ≥1 immunosuppressant in 47% of patients. Flare-free rate at 1st, 2nd and 3rd year was 86%, 73% and 62% respectively. Flares were not associated with the development of liver failure and were successfully managed with repeated doses of rituximab and/or increased corticosteroids. Three (9%) patients experienced infusion-related adverse events (1 anaphylaxis and 2 flu-like symptoms) and five (14%) infections. Conclusion Rituximab is safe and effective in patients with refractory AIH and those treated due to concomitant autoimmune or haematological disorders. 2025-10-24T10:28:41Z 2025-10-24T10:28:41Z 2024-09-27T12:06:10Z 2024-09-27T12:06:10Z 2024-09 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://hdl.handle.net/11351/11978 Liver International;44(9) https://doi.org/10.1111/liv.15970 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess Wiley Scientia