Mycophenolate Mofetil in Patients with Autoimmune Hepatitis Intolerant to Azathioprine

This study evaluated the efficacy and tolerability of mycophenolate mofetil (MMF) in 20 patients with autoimmune hepatitis (AIH) who were intolerant to azathioprine. The retrospective review included 117 patients, with 17% receiving MMF. The median age was 56 years, and the majority were female. Patients were initially treated with prednisolone and azathioprine, but azathioprine was discontinued due to adverse effects in 18 patients. MMF was administered at a median dose of 1 g twice daily alongside low-dose prednisolone. Over a median follow-up of 47 months, MMF was well tolerated, with 14 out of 19 patients remaining in remission, including those with cirrhosis. Intolerance to MMF was observed in three patients, and two had a poor response. The study concluded that MMF was a viable second-line treatment for AIH patients intolerant to azathioprine.