Azathioprine versus prednisone in non-alcoholic chronic liver disease (CLD). Relation to a serological classification

Authors

  • U. Tage-Jensen,

    Corresponding author
    1. Medical Department B, Bispebjerg Hospital, Medical Department 2, Kommunehospitalet, Medical Department A and Department of Infectious Diseases M, Rigshospitalet, Medical Department B, Frederiksberg Hospital, Medical Department, Sct. Elisabeth Hospital, Division of Hepatology and Department of Pathology, Hvidovre Hospital, Copenhagen, Institute of Medical Microbiology, Århus University, Århus, Denmark
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  • P. Schlichting,

    1. Medical Department B, Bispebjerg Hospital, Medical Department 2, Kommunehospitalet, Medical Department A and Department of Infectious Diseases M, Rigshospitalet, Medical Department B, Frederiksberg Hospital, Medical Department, Sct. Elisabeth Hospital, Division of Hepatology and Department of Pathology, Hvidovre Hospital, Copenhagen, Institute of Medical Microbiology, Århus University, Århus, Denmark
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  • J. Aldershvile,

    1. Medical Department B, Bispebjerg Hospital, Medical Department 2, Kommunehospitalet, Medical Department A and Department of Infectious Diseases M, Rigshospitalet, Medical Department B, Frederiksberg Hospital, Medical Department, Sct. Elisabeth Hospital, Division of Hepatology and Department of Pathology, Hvidovre Hospital, Copenhagen, Institute of Medical Microbiology, Århus University, Århus, Denmark
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  • P. Andersen,

    1. Medical Department B, Bispebjerg Hospital, Medical Department 2, Kommunehospitalet, Medical Department A and Department of Infectious Diseases M, Rigshospitalet, Medical Department B, Frederiksberg Hospital, Medical Department, Sct. Elisabeth Hospital, Division of Hepatology and Department of Pathology, Hvidovre Hospital, Copenhagen, Institute of Medical Microbiology, Århus University, Århus, Denmark
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  • O. Dietrichson,

    1. Medical Department B, Bispebjerg Hospital, Medical Department 2, Kommunehospitalet, Medical Department A and Department of Infectious Diseases M, Rigshospitalet, Medical Department B, Frederiksberg Hospital, Medical Department, Sct. Elisabeth Hospital, Division of Hepatology and Department of Pathology, Hvidovre Hospital, Copenhagen, Institute of Medical Microbiology, Århus University, Århus, Denmark
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  • F. Hardt,

    1. Medical Department B, Bispebjerg Hospital, Medical Department 2, Kommunehospitalet, Medical Department A and Department of Infectious Diseases M, Rigshospitalet, Medical Department B, Frederiksberg Hospital, Medical Department, Sct. Elisabeth Hospital, Division of Hepatology and Department of Pathology, Hvidovre Hospital, Copenhagen, Institute of Medical Microbiology, Århus University, Århus, Denmark
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  • L. R. Mathiesen,

    1. Medical Department B, Bispebjerg Hospital, Medical Department 2, Kommunehospitalet, Medical Department A and Department of Infectious Diseases M, Rigshospitalet, Medical Department B, Frederiksberg Hospital, Medical Department, Sct. Elisabeth Hospital, Division of Hepatology and Department of Pathology, Hvidovre Hospital, Copenhagen, Institute of Medical Microbiology, Århus University, Århus, Denmark
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  • J. O. Nielsen,

    1. Medical Department B, Bispebjerg Hospital, Medical Department 2, Kommunehospitalet, Medical Department A and Department of Infectious Diseases M, Rigshospitalet, Medical Department B, Frederiksberg Hospital, Medical Department, Sct. Elisabeth Hospital, Division of Hepatology and Department of Pathology, Hvidovre Hospital, Copenhagen, Institute of Medical Microbiology, Århus University, Århus, Denmark
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  • The Copenhagen Study Group for Liver Diseases

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    • *

      Members of the group are: Mogens Bjørneboe, Per Christoffersen, Odd Dietrichson, Viggo Faber, Gerda Høybye, Finn Hardt, Mogens Hilden, Kurt Iversen, Ove Jessen, Erik Juhl, Jørgen Lindskov, Stig Munksgaard, Jens O. Nielsen, Svend Nørregaard, Hemming Poulsen, Hanne Prytz, Klavs Ramsøe, Leo Ranek, Vagn Reinicke, Poul Schlichting, Thorkild I. A. Sørensen, Ulrik Tage-Jensen, Åge Chr. Thomsen, Niels Tygstrup and Kjeld Winkler.


Department of Infectious Diseases M Rigshospitalet Tagensvej DK-2200 Copenhagen N Denmark

Abstract

ABSTRACT— One hundred and forty-eight patients with non-alcoholic cirrhosis or chronic aggressive hepatitis entered a prospective, unblinded, randomized trial on the effect of azathioprine versus prednisone. For all 148 patients, there were no differences in survival related to the two drugs. In 99 patients the disease was classified as autoimmune, in 23 as posthepatitic, and in 26 as cryptogenic. No significant differences were seen in survival between these three groups of patients and no differences in survival related to the two drugs were registered within any of the groups. The autoimmune group included the patients with the biochemically most active disease, and a statistically significant reduction in activity was obtained with prednisone as well as azathioprine. Most remarkably, the frequencies of the autoantibodies were reduced parallel to the biochemical improvement in these patients. Immunosuppressive treatment was found to be rather ineffective in posthepatitic chronic liver disease of type B; however, no signs of activation of the hepatitis B virus were seen.

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