Risk factors for poor response to autoimmune hepatitis: a systematic review and meta-analysis - 01/06/26
, Honglan Liu 2, ⁎ , Hongquan Pang 2, ⁎ Highlights |
• | The treatment response of patients with autoimmune hepatitis is related to the prognosis. |
• | Age, platelet count, IgG, SMA, mild liver fibrosis, rosettes and cirrhosis were found to be predictors of treatment response to autoimmune hepatitis. |
• | This study was conducted in accordance with the PRISMA guidelines, used the GRADEpro for evidence assessment. |
Abstract |
Background |
Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease and its prognosis is closely related to treatment response. This meta-analysis aimed to identify baseline predictors of treatment response in AIH.
Methods |
PubMed, Embase, Ovid MEDLINE, and the Cochrane Library were searched from inception to August 24, 2025. Study quality was assessed independently by two reviewers using the Newcastle–Ottawa Scale. Standardized mean differences (SMDs), odds ratios (ORs), and 95% confidence interval (CIs) were pooled using random-effects models. Subgroup analyses, sensitivity analysis and evidence certainty assessment were also performed.
Results |
Forty-eight studies were included. Favorable treatment response was associated with older age (SMD: 0.41, 95% CI: 0.23–0.58), lower immunoglobulin G (IgG) levels (SMD: -0.71, 95% CI: -1.04 to -0.37), higher platelet count (SMD: 0.28, 95% CI: 0.03–0.54), mild fibrosis (OR: 0.15, 95% CI: 0.07–0.35), and rosette formation (OR: 0.21, 95% CI: 0.07–0.67). Poor treatment response was associated with smooth muscle antibodies (SMA) (OR: 1.42, 95% CI: 1.10–1.84) and baseline cirrhosis (OR: 2.61, 95% CI: 1.69–4.02).
Conclusion |
Age, platelet count, IgG level, SMA, mild liver fibrosis, rosettes, and cirrhosis were associated with treatment response in AIH and may help inform risk stratification.
Registry and the registration no. of study |
PROSPERO registration number CRD42024623543.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Explore the risk factors of biochemical responses in autoimmune hepatitis
Through literature retrieval and screening, as well as combined effect sizes, the protective and risk factors influencing the biochemical response of autoimmune hepatitis were identified.
Keywords : autoimmune hepatitis, risk factors, biochemical response, predictors, treatment
Plan
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