Isolated IgG elevation in patients with persistently normal transaminases does not affect the outcome of autoimmune hepatitis
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background & Aims: The goal of treatment for autoimmune hepatitis is to achieve a complete biochemical response, defined as normalization of transaminases and immunoglobulin G (IgG) levels. Recent data suggest that IgG normalization does not significantly affect survival. We evaluated the impact of persistently elevated IgG levels (IgGe) and IgG flares (IgGf) on fibrosis progression and cirrhosis development. Methods: This retrospective multicenter cohort study included 493 patients with autoimmune hepatitis and persistently normal transaminase levels during follow-up. The inverse probability of treatment weighting (IPTW) propensity score method was used to balance the cohorts. Results: = 0.211). Conclusions: Persistent or temporary serum IgG elevation in patients with normal transaminase levels did not significantly affect autoimmune hepatitis disease progression, thus challenging the current definition of complete biochemical response. Impact and implications: The body of evidence showing a lesser impact of immunoglobulin G (IgG)values on outcomes in patients with autoimmune hepatitis (AIH) is growing. However, there is still a lack of robust information on the long-term outcomes, especially in patients who achieve persistent transaminase normalization. Persistently elevated IgG or IgG flares in patients with persistently normal transaminases do not seem to affect outcomes in patients with AIH. These results challenge the current definition of complete biochemical response in patients with AIH. Transaminase level normalization appeared to be the best treatment endpoint.
Source: JHEP Reports
Authors: Álvaro Díaz-González, Ida Schregel, Lorena Carballo, Carmen Álvarez-Navascués, Enrique Frisancho-Morales, Mireia Miquel, Montserrat García Retortillo, Judith Gómez, Diana Horta, Beatriz Mateos, Bastian Engel, Felix Volmer, María del Barrio, Sergio Rodríguez-Tajes, Ignasi Olivas, Johannes Hartl, Carla Amaral González, Manuel Hernández-Guerra, Inmaculada Castello, Indhira Pérez-Medrano, Jesús M. González-Santiago, Ana Arencibía, Alberto Gómez, Manuel Rodríguez-Perálvarez, Javier Crespo, Margarita Sala, Magdalena Salcedo, Ana Barreira-Díaz, Mar Riveiro-Barciela, Richard Taubert, Christoph Schramm, María-Carlota Londoño
Institutions: Marqués de Valdecilla University Hospital, Instituto de Investigación Marqués de Valdecilla, University Medical Center Hamburg-Eppendorf, ERN RARE-LIVER, Hospital Universitario Central de Asturias, Universitat Autònoma de Barcelona, Corporació Sanitària Parc Taulí, Institute of Research and Innovation Parc Tauli, Hospital Del Mar, Parc de Salut, Hospital Universitario de Burgos, University Hospital Mútua de Terrassa, Mútua Terrassa, Instituto Ramón y Cajal de Investigación Sanitaria, Hospital Universitario Ramón y Cajal, Medizinische Hochschule Hannover, Hospital Clínic de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Fundació de Recerca Clínic Barcelona-Institut d’Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Hospital Universitario de Canarias, Hospital General Universitario De Valencia, Complejo Hospitalario de Pontevedra, Complejo Hospitalario de Salamanca, Instituto de Investigación Biomédica de Salamanca, Hospital Universitario Nuestra Señora de Candelaria, Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Universitario Reina Sofía, Institut d'Investigació Biomèdica de Girona, Hospital Universitari de Girona Doctor Josep Trueta, Hospital General Universitario Gregorio Marañón, Vall d'Hebron Hospital Universitari
Language: English
Topic: Liver Diseases and Immunity
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,110
Funders: Asociación Española para el Estudio del Hígado, European Commission, Deutsche Forschungsgemeinschaft, Medizinischen Hochschule Hannover, Universitat de Barcelona, Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Investigación Marqués de Valdecilla, Instituto de Salud Carlos III, Universitätsklinikum Hamburg-Eppendorf, Hospital Clínic de Barcelona
OpenAlex ID: W4413805298