Risk factors for poor response to autoimmune hepatitis: A systematic review and meta-analysis

Area of Science:

• Hepatology
• Immunology
• Internal Medicine

Background:

• Autoimmune hepatitis (AIH) is a chronic liver disease where prognosis depends on treatment response.
• Identifying baseline predictors is crucial for managing AIH effectively.

Purpose of the Study:

• To conduct a meta-analysis identifying baseline predictors of treatment response in autoimmune hepatitis (AIH).

Main Methods:

• Systematic literature search of PubMed, Embase, Ovid MEDLINE, and Cochrane Library.
• Quality assessment using the Newcastle-Ottawa Scale and data pooling via random-effects models.
• Inclusion of 48 studies with analysis of standardized mean differences (SMDs) and odds ratios (ORs).

Main Results:

• Favorable response linked to older age, lower IgG, higher platelets, mild fibrosis, and rosette formation.
• Poor response associated with smooth muscle antibodies (SMA) and baseline cirrhosis.
• Statistical significance confirmed with 95% confidence intervals (CIs).

Conclusions:

• Baseline factors including age, platelet count, IgG levels, SMA, mild fibrosis, rosettes, and cirrhosis predict AIH treatment response.
• These predictors can aid in risk stratification for AIH patients.
• PROSPERO registration number CRD42024623543.