Treatment of Autoimmune Hepatitis
Jun 07, 2022
Source: Cainiu Health
Dr. Jin Zhongkui
Introduction
Alternative therapies are available for autoimmune hepatitis. Alternative drug regimens may be considered for patients who fail to achieve histological remission with high-dose glucocorticoid therapy or who cannot tolerate drug-related adverse effects. Cyclosporine A, tacrolimus, and budesonide may be effective in adult patients with glucocorticoid-resistant disease. Patients with fulminant hepatic failure prior to liver transplantation have a high risk of disease recurrence.
Ordinarily, one rarely hears about autoimmune hepatitis (AIH), a very rare disease. So, what are the treatment options for autoimmune hepatitis?
Treatment Options for Autoimmune Hepatitis
Alternative therapies are available for AIH. Patients who fail to achieve histological remission despite high-dose glucocorticoid therapy—or who cannot tolerate drug-related adverse effects—may be considered for alternative pharmacologic regimens. Adult patients resistant to glucocorticoids may respond to cyclosporine A, tacrolimus, or budesonide. For those intolerant to azathioprine, alternatives such as 6-mercaptopurine or mycophenolate mofetil may be attempted. Additionally, ursodeoxycholic acid, methotrexate, and cyclophosphamide have also been explored.
Pharmacologic therapy. The primary goals of AIH treatment are symptom relief, improvement of liver function and histopathological abnormalities, and slowing the progression of hepatic fibrosis. Monotherapy with glucocorticoids or combination therapy with glucocorticoids plus azathioprine currently represents the standard treatment for AIH. Patients with fulminant hepatic failure prior to liver transplantation face a high risk of disease recurrence. Recurrent disease is managed with prednisone monotherapy or prednisone combined with azathioprine; most patients achieve effective disease control, thereby improving transplant success rates and survival.
The main objectives of AIH treatment are symptom relief, improvement of liver function and histopathological abnormalities, and slowing the progression of hepatic fibrosis. Glucocorticoid monotherapy or combination therapy with azathioprine remains the current standard of care for AIH. We hope this article has been helpful to you. Wishing you a joyful life and good health!
