Evidence map›Paper›PMID 40687326›Full record

ArticleGastroenterology research2025

Efficacy and Safety of Mycophenolate Mofetil Compared to Azathioprine in Autoimmune Hepatitis: A Meta-Analysis.

Shahryar Khan, Mashal Alam Khan, Aamer Ahmad, Hamza Asif, Muhammad Safwan, Asmad Khan, Muhammad Waqar Elahi, Mihir Prakash Shah, Yousaf Zafar

Abstract read
In one paragraph

Article in Gastroenterology research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Shahryar KhanDepartment of Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
Mashal Alam KhanKhyber Medical University, Peshawar, Pakistan.
Aamer AhmadKhyber Medical University, Peshawar, Pakistan.
Hamza AsifDepartment of Medicine, University of Louisville, Louisville, KY, USA.
Muhammad SafwanKhyber Medical University, Peshawar, Pakistan.
Asmad KhanKhyber Medical University, Peshawar, Pakistan.
Muhammad Waqar ElahiDepartment of Medicine, West Virginia University School of Medicine, Morgantown, WV, USA.
Mihir Prakash ShahDepartment of Medicine, University of Oklahoma, Norman, OK, USA.
Yousaf ZafarDepartment of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Mycophenolate mofetil (MMF) has been suggested as a potential alternative treatment option for patients who are intolerant or unresponsive to the standard corticosteroid and azathioprine (AZA) regimen for autoimmune hepatitis (AIH). This systematic review and meta-analysis aimed to comprehensively evaluate and compare the biochemical efficacy and safety profiles of MMF and AZA in the treatment of AIH. Methods: This review systematically examined the available literature from the inception of the MEDLINE and EMBASE databases up to November 2024. The primary outcomes of interest included the evaluation of biochemical remission (BR), the effectiveness of MMF in patients who were non-responsive (AZA-NR) or intolerant to azathioprine (AZA-IT), and the assessment of adverse events (AEs) and overall survival. Results: This meta-analysis evaluated 11 studies comprising 952 participants, with 57.45% receiving MMF and the remaining receiving AZA. The findings indicate that MMF demonstrated a significantly higher BR rate (88.57%) than AZA (53.64%). The pooled analysis revealed a substantial improvement in the BR rate with MMF compared to AZA (odds ratio (OR): 7.81, 95% confidence interval (CI): 2.21 - 27.69). Furthermore, the estimated enhancement in treatment efficacy with MMF was 61% (95% CI: 42.63 - 78.04) among AZA-NR patients and 61.73% (95% CI: 54.88 - 68.35) in AZA-IT patients. However, the analysis did not reveal any significant differences between the two groups in terms of AEs (OR: 0.57, P = 0.47) and overall survival (OR: 1.27, P = 0.64). Conclusions: MMF may be a suitable first-line alternative to AZA for AIH, with higher rates of BR, especially in patients intolerant or non-responsive to standard therapy. However, the long-term efficacy and safety of MMF requires further investigation through rigorous randomized controlled trials.

Indexed as

Adverse eventsAIHAZABiochemical remissionIntolerantMMFNon-responsiveTreatment-naive

Identifiers

PMID40687326
PMCPMC12267078

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.