title: Chloroquine for the maintenance of remission of autoimmune hepatitis: results of a pilot study.
abstract: BACKGROUND
  Due to the risks related to long-term treatment with prednisone and azathioprine, most clinicians try to withdraw these drugs when patients with autoimmune hepatitis are in remission. However, there is a high probability of relapse, and most patients end up receiving maintenance treatment.
  
  
  OBJECTIVE
  To evaluate the safety and efficacy of maintenance treatment with chloroquine in the prevention of autoimmune hepatitis relapses.
  
  
  METHODS
  Classical treatment was stopped after achievement of biochemical and histological remission of autoimmune hepatitis. Chloroquine diphosphate, 250 mg daily, was given for at least 12 months or until the occurrence of relapses defined by levels of aminotransferases at least twice the upper normal values.
  
  
  RESULTS
  Fourteen patients were consecutively treated and compared with 18 historical controls. There was a 6.49 (1.38-30.30) greater chance of relapse in the historical controls when compared with patients treated with chloroquine (72.2% x 23.5%; 0.031).
  
  
  CONCLUSIONS
  The group treated with chloroquine had a lower frequency of relapses. Chloroquine was safe in patients with autoimmune hepatitis and hepatic cirrhosis without decompensation, on 250 mg daily up to 2 years. These preliminary results provide a basis for upcoming controlled studies comparing chloroquine with placebo or for maintenance treatment with prednisone and/or azathioprine for the prevention of autoimmune hepatitis relapses.
authors.affiliation: Department of Gastroenterology, Institute of Tropical Medicine, University of São Paulo School of Medicine, São Paulo, SP, Brazil.
authors.forename: Marcos
authors.initials: M
authors.lastname: Mucenic
authors.forename: Evandro Sobroza de
authors.initials: ES
authors.lastname: Mello
authors.forename: Eduardo Luiz R
authors.initials: EL
authors.lastname: Cançado
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D016022:Case-Control Studies; D002738:Chloroquine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D019693:Hepatitis, Autoimmune / Q000188:drug therapy* / Q000201:enzymology; D006801:Humans; D008297:Male; D010865:Pilot Projects; D012074:Remission Induction; D055502:Secondary Prevention; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; C023676:chloroquine diphosphate; D002738:Chloroquine