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The Efficacy of Mycophenolate Mofetil for the Treatment of Autoimmune Hepatitis: A Meta-Analysis and Systematic Review

2016· article· en· W2977249171 on OpenAlexaff
Sheila D. Rustgi, Ioannis T. Konstantinidis, Rachel Pinotti, Thomas D. Schiano, Malcolm Wells

Bibliographic record

VenueThe American Journal of Gastroenterology · 2016
Typearticle
Languageen
FieldMedicine
TopicLiver Diseases and Immunity
Canadian institutionsRoyal Victoria Regional Health Centre
Fundersnot available
KeywordsMedicineAzathioprineInternal medicineAutoimmune hepatitisPrednisoneRandomized controlled trialMycophenolateMeta-analysisPlaceboGastroenterologyClinical trialMEDLINEHepatitisTransplantationDiseaseAlternative medicinePathology

Abstract

fetched live from OpenAlex

Introduction: In patients with autoimmune hepatitis (AIH), standard treatment is azathioprine and prednisone. We performed a systematic review and meta-analysis to determine the safety and efficacy of mycophenolate mofetil (MMF) in the treatment of AIH. Methods: We systematically searched PubMed/MEDLINE, EMBASE and CENTRAL to identify randomized and non-randomized controlled trials of MMF administered to patients with AIH. Two independent investigators assessed trial eligibility and abstracted data. Results: Our study identified 789 citations, of which 14 studies were reviewed in full. Of these, 4 trials with 279 patients met our eligibility criteria. Comparing treatment with MMF versus control, there was no significant difference in rates of clinical remission (OR 0.37, 95% CI 0.01-14.03, p=0.59, I2=79%), AST improvement (OR 0.04, 95% CI 0.00-1.01, p=0.05, I2 n/a), or bilirubin improvement (OR 0.47, 95% CI 0.03-8.60, p=0.61, I2 n/a). There was a trend towards less treatment failure in patients treated with MMF than in patients in the control group (OR 0.88, 95% CI 0.00-394.24, p=0.97, I2=91%). No deaths were reported in either treatment or control groups. Conclusion: There was not a significant difference in the clinical remission rate or improvement in specifi c laboratory values between patients treated with MMF and placebo/control. Given the scant data identified in this comprehensive systematic review, larger controlled studies are needed to evaluate the use of MMF in the treatment of AIH.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.014
metaresearch head score (Gemma)0.036
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Meta-analysis · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.018
Threshold uncertainty score0.074

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0140.036
Meta-epidemiology (narrow)0.0020.001
Meta-epidemiology (broad)0.0180.030
Bibliometrics0.0070.007
Science and technology studies0.0010.001
Scholarly communication0.0030.002
Open science0.0020.001
Research integrity0.0020.002
Insufficient payload (model declined to judge)0.0030.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.024
GPT teacher head0.292
Teacher spread0.268 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designMeta-analysis
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2016
Admission routes1
Has abstractyes

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