Mycophenolate Mofetil for Autoimmune Hepatitis Patients Who Can’t Tolerate Azathioprine

In most cases, patients with autoimmune hepatitis (AIH) can be treated successfully with prednisone, with or without azathioprine. However, in as many as 20% of AIH patients, azathioprine is tolerated poorly or is ineffective. Possible alternatives to azathioprine for such patients include methotrexate or mycophenolate mofetil (MMF).

In this retrospective study, researchers in San Francisco investigated the efficacy of MMF in 15 AIH patients (mean age, 60; 73% women; 13 with type 1 AIH; 2 with overlap syndrome [AIH plus primary biliary cirrhosis]) who developed unacceptable side effects from prednisone plus azathioprine or had suboptimal response (defined as progressively active disease as assessed by liver biopsy), persistently increasing l…