Prednisone/Prednisolone And Azathioprine For The Treatment Of Autoimmune Hepatitis:a Meta-analysis

Background&Aims Prednisone/prednisolone with or without azathioprine isconsidered the mainstay in the treatment of autoimmune hepatitis(AIH), but with thedeepening of research, many therapeutic options are available. The primary objective ofthis reaserch was to evaluate the effective of glucocorticoid and immunosuppressants onautoimmune hepatitis (AIH) and long-term remission rate by exploring the publishedliterature on the optimal induction.Methods By searching MEDLINE (Ovid platform), PubMed, CBM, Weipu database,Chinese Journal Full-text Database and Wanfang database of Chinese journals,choosing randomized controlled trials of corticosteroids, immunosuppressive agents andother effective drug treatments into effect of autoimmune hepatitis.Meta analysis wasconducted with the aid of Cohrane collaboration’s software Review Manager5.2.Results Eleven clinical controlled trials were enroled and analyzed,and578patientswere included:3treatment naive,2relapse,2both of them.And the other4studiesassessed maintenance therapy.All studies studied prednisone/prednisolone (PRED),azathioprine (AZA) or combinationPRED+AZA except one maintenance study(thymostimulin versus no therapy). Result showed that PRED+AZA in treatment AIHis better than the therapy of PRED (RR=0.71,95%CI：0.54-0.94). AZA monotherapy asinduction has a high mortality rate (30%). There is no difference in the incidence ofadvers reaction and motality between PRED+AZA and PREDmonotherapyConclusions1.PRED+AZA combination therapy is better than PRED monotherapyfor AIH treatment. And there is no difference in the incidence of advers reaction andmotality between PRED+AZA and PREDmonotherapy.2.AZA monotherapy asinduction was considered as not viable because of a high mortality rate.