Abstract
Autoimmune hepatitis (AIH) is an immune-mediated necroinflammatory condition of the liver. Presentation can vary from the asymptomatic individual with abnormal liver function test to fulminant liver failure. The diagnosis is based on the combination of biochemical, autoimmune, and histological parameters, and exclusion of other liver diseases. Standard therapy consists of a combination of corticosteroids and azathioprine, which is efficacious in 80% of patients. Alternative therapies are increasingly being explored in patients who do not respond to the standard treatment and/or have unacceptable adverse effects. This review examines the role of alternative drugs (second-line agents) available for AIH treatment non-responders. These agents include budesonide, mycophenolate mofetil, cyclosporin, tacrolimus, 6-mercaptopurine, 6-thioguanine, rituximab, ursodeoxycholic acid, rapamycin, and methotrexate. In addition, the risk of opportunistic infections and malignancies are discussed. A treatment algorithm is proposed for the management of patients with AIH treatment non-responders.
| Original language | English |
|---|---|
| Pages (from-to) | 619-627 |
| Number of pages | 0 |
| Journal | J Gastroenterol Hepatol |
| Volume | 26 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Apr 2011 |
UN SDGs
This output contributes to the following UN Sustainable Development Goals (SDGs)
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SDG 3 Good Health and Well-being
Keywords
- Drug Therapy
- Combination
- Evidence-Based Medicine
- Hepatitis
- Autoimmune
- Humans
- Immunosuppressive Agents
- Practice Guidelines as Topic
- Predictive Value of Tests
- Treatment Outcome
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