TY - JOUR
T1 - Development and validation of a prognostic score for long-term transplant-free survival in autoimmune hepatitis type 1
AU - Biewenga, Maaike
AU - Verhelst, Xavier P. D. M. J.
AU - Baven-Pronk, Martine A. M. C.
AU - Putter, Hein
AU - van den Berg, Aad P.
AU - van Nieuwkerk, Karin C. M. J.
AU - van Buuren, Henk R.
AU - Bouma, Gerd
AU - de Boer, Ynte S.
AU - Simoen, Cedric
AU - Colle, Isabelle
AU - Schouten, Jeoffrey
AU - Sermon, Filip
AU - van Steenkiste, Christophe
AU - van Vlierberghe, Hans
AU - van der Meer, Adriaan J.
AU - Nevens, Frederik
AU - van Hoek, Bart
AU - Drenth, J. P. H.
AU - van Gerven, N. M.
AU - Beuers, U.
AU - van Erpecum, K. J.
AU - den Ouden, J. W.
AU - Bhalla, A.
AU - Brouwer, J. T.
AU - Vrolijk, J. M.
AU - Koek, G. H.
AU - Guichelaar, M. M. J.
AU - van der Wouden, E. J.
AU - van Meyel, J. J. M.
AU - Baak, L. C.
AU - Verdonk, R. C.
AU - Klemt-Kropp, M.
AU - Verhagen, M. A. M. T.
AU - Kuijvenhoven, J.
AU - Dutch Autoimmune Hepatitis Study group
AU - de Jonge, H. M.
N1 - Funding Information: We thank the other members of the Dutch Auto‐Immune Hepatitis Study Group for fruitful discussions regarding the manuscript: J.P.H. Drenth (Radboud UMC Nijmegen); N.M. van Gerven (Rode Kruis ziekenhuis; Beverwijk); U. Beuers (AMC Amsterdam); K.J. van Erpecum (UMCU Utrecht); J.W. den Ouden and A. Bhalla (Hagaziekenhuis den Haag); J.T. Brouwer (Reinier de Graaf Gasthuis Delft); J.M. Vrolijk (Rijnstate hospital Arnhem); G.H. Koek (MUMC, Maastricht); M.M.J. Guichelaar (Medisch Spectrum Twente, Enschede); E.J. van der Wouden (Isala hospital Zwolle); J.J.M van Meyel and L.C. Baak (OLVG, Amsterdam); R.C. Verdonk (St. Antonius Hospital Nieuwegein); M. Klemt‐Kropp (Noordwest Ziekenhuisgroep Alkmaar); M.A.M.T. Verhagen (Diakonessenhuis, Utrecht); J. Ph. Kuijvenhoven (Spaarne Gasthuis Haarlem); H.M. de Jonge (Jeroen Bosch ziekenhuis den Bosch); MB was supported by unrestricted grants from Zambon Pharma. No other financial support received for this study. Publisher Copyright: © 2021 The Authors. UEG Journal published by Wiley Periodicals LLC. on behalf of United European Gastroenterology. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/7/1
Y1 - 2021/7/1
N2 - Background: No prognostic score is currently available for long-term survival in autoimmune hepatitis (AIH) patients. Objective: The aim of this study was to develop and validate such a prognostic score for AIH patients at diagnosis. Methods: The prognostic score was developed using uni- & multivariate Cox regression in a 4-center Dutch cohort and validated in an independent 6-center Belgian cohort. Results: In the derivation cohort of 396 patients 19 liver transplantations (LTs) and 51 deaths occurred (median follow-up 118 months; interquartile range 60–202 months). In multivariate analysis age (hazard ratio [HR] 1.045; p < 0.001), non-caucasian ethnicity (HR 1.897; p = 0.045), cirrhosis (HR 3.266; p < 0.001) and alanine aminotransferase level (HR 0.725; p = 0.003) were significant independent predictors for mortality or LT (C-statistic 0.827; 95% CI 0.790–0.864). In the validation cohort of 408 patients death or LT occurred in 78 patients during a median follow-up of 74 months (interquartile range: 25–142 months). Predicted 5-year event rate did not differ from observed event rate (high risk group 21.5% vs. 15.7% (95% CI: 6.3%–24.2%); moderate risk group 5.8% versus 4.3% (95% CI: 0.0%–9.1%); low risk group 1.9% versus 5.4% (95% CI: 0.0%–11.4%); C-statistic 0.744 [95% CI 0.644–0.844]). Conclusions: A Dutch-Belgian prognostic score for long-term transplant-free survival in AIH patients at diagnosis was developed and validated.
AB - Background: No prognostic score is currently available for long-term survival in autoimmune hepatitis (AIH) patients. Objective: The aim of this study was to develop and validate such a prognostic score for AIH patients at diagnosis. Methods: The prognostic score was developed using uni- & multivariate Cox regression in a 4-center Dutch cohort and validated in an independent 6-center Belgian cohort. Results: In the derivation cohort of 396 patients 19 liver transplantations (LTs) and 51 deaths occurred (median follow-up 118 months; interquartile range 60–202 months). In multivariate analysis age (hazard ratio [HR] 1.045; p < 0.001), non-caucasian ethnicity (HR 1.897; p = 0.045), cirrhosis (HR 3.266; p < 0.001) and alanine aminotransferase level (HR 0.725; p = 0.003) were significant independent predictors for mortality or LT (C-statistic 0.827; 95% CI 0.790–0.864). In the validation cohort of 408 patients death or LT occurred in 78 patients during a median follow-up of 74 months (interquartile range: 25–142 months). Predicted 5-year event rate did not differ from observed event rate (high risk group 21.5% vs. 15.7% (95% CI: 6.3%–24.2%); moderate risk group 5.8% versus 4.3% (95% CI: 0.0%–9.1%); low risk group 1.9% versus 5.4% (95% CI: 0.0%–11.4%); C-statistic 0.744 [95% CI 0.644–0.844]). Conclusions: A Dutch-Belgian prognostic score for long-term transplant-free survival in AIH patients at diagnosis was developed and validated.
KW - AIH
KW - autoimmune hepatitis
KW - autoimmune liver disease
KW - liver transplantation
KW - long-term survival
KW - mortality
KW - prognostic score
KW - risk stratification
KW - transplant-free survival
KW - validation
UR - http://www.scopus.com/inward/record.url?scp=85111358971&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/ueg2.12112
DO - https://doi.org/10.1002/ueg2.12112
M3 - Article
C2 - 34165262
SN - 2050-6406
VL - 9
SP - 662
EP - 671
JO - United European gastroenterology journal
JF - United European gastroenterology journal
IS - 6
ER -