Publication

Adverse events related to low dose corticosteroids in autoimmune hepatitis

Dutch Autoimmune Hepatitis Study G, van den Brand, F. F., van der Veen, K. S., Lissenberg-Witte, B., de Boer, Y. S., van Hoek, B., Drenth, J. P. H., Verdonk, R. C., Vrolijk, J. M., van Nieuwkerk, C. M. J. & Bouma, G., 15-Oct-2019, In : Alimentary Pharmacology & Therapeutics. 7 p.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Dutch Autoimmune Hepatitis Study G, van den Brand, F. F., van der Veen, K. S., Lissenberg-Witte, B., de Boer, Y. S., van Hoek, B., ... Bouma, G. (2019). Adverse events related to low dose corticosteroids in autoimmune hepatitis. Alimentary Pharmacology & Therapeutics. https://doi.org/10.1111/apt.15528

Author

Dutch Autoimmune Hepatitis Study G ; van den Brand, Floris F. ; van der Veen, Koen S. ; Lissenberg-Witte, Birgit ; de Boer, Ynto S. ; van Hoek, Bart ; Drenth, Joost P. H. ; Verdonk, Robert C. ; Vrolijk, Jan M. ; van Nieuwkerk, Carin M. J. ; Bouma, Gerd. / Adverse events related to low dose corticosteroids in autoimmune hepatitis. In: Alimentary Pharmacology & Therapeutics. 2019.

Harvard

Dutch Autoimmune Hepatitis Study G, van den Brand, FF, van der Veen, KS, Lissenberg-Witte, B, de Boer, YS, van Hoek, B, Drenth, JPH, Verdonk, RC, Vrolijk, JM, van Nieuwkerk, CMJ & Bouma, G 2019, 'Adverse events related to low dose corticosteroids in autoimmune hepatitis', Alimentary Pharmacology & Therapeutics. https://doi.org/10.1111/apt.15528

Standard

Adverse events related to low dose corticosteroids in autoimmune hepatitis. / Dutch Autoimmune Hepatitis Study G; van den Brand, Floris F.; van der Veen, Koen S.; Lissenberg-Witte, Birgit; de Boer, Ynto S.; van Hoek, Bart; Drenth, Joost P. H.; Verdonk, Robert C.; Vrolijk, Jan M.; van Nieuwkerk, Carin M. J.; Bouma, Gerd.

In: Alimentary Pharmacology & Therapeutics, 15.10.2019.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Dutch Autoimmune Hepatitis Study G, van den Brand FF, van der Veen KS, Lissenberg-Witte B, de Boer YS, van Hoek B et al. Adverse events related to low dose corticosteroids in autoimmune hepatitis. Alimentary Pharmacology & Therapeutics. 2019 Oct 15. https://doi.org/10.1111/apt.15528


BibTeX

@article{0b06aee2a79e40599bfc519cb26c3f07,
title = "Adverse events related to low dose corticosteroids in autoimmune hepatitis",
abstract = "Background Autoimmune hepatitis requires long-term therapy, and systemic corticosteroids are the backbone of therapeutic management. Prolonged use of corticosteroids may lead to adverse events but data from long-term studies are mainly derived from studies in rheumatic diseases. Aim To assess cataract, diabetes and fractures in relation to corticosteroid doses in the long-term maintenance treatment of patients with autoimmune hepatitis. Methods We retrospectively collected data on 476 patients (77{\%} women) with an established diagnosis of autoimmune hepatitis. Binary logistic regression with a generalised estimating equation was used to analyse the association between current corticosteroid use and the incidence of cataract, diabetes and fractures with onset after autoimmune hepatitis diagnosis. We corrected for sex, age, cirrhosis at diagnosis and predniso(lo)ne use in the prior 3 years to account for possible ongoing effects. Results A total of 6634 years, with a median of 13 (range 1-40) per patient were recorded. The median age at diagnosis was 44 years (range 2-88). Adverse events were documented in 120 (25{\%}) patients. Low-dose predniso(lo)ne (0.1-5.0 mg/d) increased the odds of fractures whereas higher doses (>5.0 mg/d) increased the odds of cataracts and diabetes. Budesonide increased the odds of cataract and fractures; this effect was independent of predniso(lo)ne use in the prior 1, 2 or 3 years. Conclusions Even low doses of corticosteroids frequently lead to substantial adverse events refuting the assumption that adverse events are prevented by administering low doses.",
keywords = "ACTIVE LIVER-DISEASE, CONTROLLED-TRIAL, AZATHIOPRINE, BUDESONIDE, REMISSION, PREDNISONE, WITHDRAWAL, EFFICACY, THERAPY",
author = "{Dutch Autoimmune Hepatitis Study G} and {van den Brand}, {Floris F.} and {van der Veen}, {Koen S.} and Birgit Lissenberg-Witte and {de Boer}, {Ynto S.} and {van Hoek}, Bart and Drenth, {Joost P. H.} and Verdonk, {Robert C.} and Vrolijk, {Jan M.} and {van Nieuwkerk}, {Carin M. J.} and Gerd Bouma and {van Gerven}, {N. M.} and Kuijvenhoven, {J. Ph} and Schreuder, {T. C. M. A.} and {van der Wouden}, {E. J.} and {van Meyel}, {J. J. M.} and Baak, {L. C.} and Stadhouders, {P. H. G. M.} and M. Klemt-Kropp and Verhagen, {M. A. M. T.} and A. Bhalla and {den Ouden}, {J. W.} and U. Beuers and {van Erpecum}, {K. J.} and {van Buuren}, {H. R.} and Brouwer, {J. T.}",
year = "2019",
month = "10",
day = "15",
doi = "10.1111/apt.15528",
language = "English",
journal = "Alimentary Pharmacology & Therapeutics",
issn = "0269-2813",
publisher = "Wiley",

}

RIS

TY - JOUR

T1 - Adverse events related to low dose corticosteroids in autoimmune hepatitis

AU - Dutch Autoimmune Hepatitis Study G

AU - van den Brand, Floris F.

AU - van der Veen, Koen S.

AU - Lissenberg-Witte, Birgit

AU - de Boer, Ynto S.

AU - van Hoek, Bart

AU - Drenth, Joost P. H.

AU - Verdonk, Robert C.

AU - Vrolijk, Jan M.

AU - van Nieuwkerk, Carin M. J.

AU - Bouma, Gerd

AU - van Gerven, N. M.

AU - Kuijvenhoven, J. Ph

AU - Schreuder, T. C. M. A.

AU - van der Wouden, E. J.

AU - van Meyel, J. J. M.

AU - Baak, L. C.

AU - Stadhouders, P. H. G. M.

AU - Klemt-Kropp, M.

AU - Verhagen, M. A. M. T.

AU - Bhalla, A.

AU - den Ouden, J. W.

AU - Beuers, U.

AU - van Erpecum, K. J.

AU - van Buuren, H. R.

AU - Brouwer, J. T.

PY - 2019/10/15

Y1 - 2019/10/15

N2 - Background Autoimmune hepatitis requires long-term therapy, and systemic corticosteroids are the backbone of therapeutic management. Prolonged use of corticosteroids may lead to adverse events but data from long-term studies are mainly derived from studies in rheumatic diseases. Aim To assess cataract, diabetes and fractures in relation to corticosteroid doses in the long-term maintenance treatment of patients with autoimmune hepatitis. Methods We retrospectively collected data on 476 patients (77% women) with an established diagnosis of autoimmune hepatitis. Binary logistic regression with a generalised estimating equation was used to analyse the association between current corticosteroid use and the incidence of cataract, diabetes and fractures with onset after autoimmune hepatitis diagnosis. We corrected for sex, age, cirrhosis at diagnosis and predniso(lo)ne use in the prior 3 years to account for possible ongoing effects. Results A total of 6634 years, with a median of 13 (range 1-40) per patient were recorded. The median age at diagnosis was 44 years (range 2-88). Adverse events were documented in 120 (25%) patients. Low-dose predniso(lo)ne (0.1-5.0 mg/d) increased the odds of fractures whereas higher doses (>5.0 mg/d) increased the odds of cataracts and diabetes. Budesonide increased the odds of cataract and fractures; this effect was independent of predniso(lo)ne use in the prior 1, 2 or 3 years. Conclusions Even low doses of corticosteroids frequently lead to substantial adverse events refuting the assumption that adverse events are prevented by administering low doses.

AB - Background Autoimmune hepatitis requires long-term therapy, and systemic corticosteroids are the backbone of therapeutic management. Prolonged use of corticosteroids may lead to adverse events but data from long-term studies are mainly derived from studies in rheumatic diseases. Aim To assess cataract, diabetes and fractures in relation to corticosteroid doses in the long-term maintenance treatment of patients with autoimmune hepatitis. Methods We retrospectively collected data on 476 patients (77% women) with an established diagnosis of autoimmune hepatitis. Binary logistic regression with a generalised estimating equation was used to analyse the association between current corticosteroid use and the incidence of cataract, diabetes and fractures with onset after autoimmune hepatitis diagnosis. We corrected for sex, age, cirrhosis at diagnosis and predniso(lo)ne use in the prior 3 years to account for possible ongoing effects. Results A total of 6634 years, with a median of 13 (range 1-40) per patient were recorded. The median age at diagnosis was 44 years (range 2-88). Adverse events were documented in 120 (25%) patients. Low-dose predniso(lo)ne (0.1-5.0 mg/d) increased the odds of fractures whereas higher doses (>5.0 mg/d) increased the odds of cataracts and diabetes. Budesonide increased the odds of cataract and fractures; this effect was independent of predniso(lo)ne use in the prior 1, 2 or 3 years. Conclusions Even low doses of corticosteroids frequently lead to substantial adverse events refuting the assumption that adverse events are prevented by administering low doses.

KW - ACTIVE LIVER-DISEASE

KW - CONTROLLED-TRIAL

KW - AZATHIOPRINE

KW - BUDESONIDE

KW - REMISSION

KW - PREDNISONE

KW - WITHDRAWAL

KW - EFFICACY

KW - THERAPY

U2 - 10.1111/apt.15528

DO - 10.1111/apt.15528

M3 - Article

JO - Alimentary Pharmacology & Therapeutics

JF - Alimentary Pharmacology & Therapeutics

SN - 0269-2813

ER -

ID: 99958716