Autoimmune hepatitis: Standard treatment and systematic review of alternative treatments

World Journal of Gastroenterology : WJG
Benedetta Terziroli Beretta-PiccoliDiego Vergani


Autoimmune hepatitis is a rare chronic inflammatory liver disease, affecting all ages, characterised by elevated transaminase and immunoglobulin G levels, positive autoantibodies, interface hepatitis at liver histology and good response to immunosuppressive treatment. If untreated, it has a poor prognosis. The aim of this review is to summarize the evidence for standard treatment and to provide a systematic review on alternative treatments for adults and children. Standard treatment is based on steroids and azathioprine, and leads to disease remission in 80%-90% of patients. Alternative first line treatment has been attempted with budesonide or cyclosporine, but their superiority compared to standard treatment remains to be demonstrated. Second-line treatments are needed for patients not responding or intolerant to standard treatment. No randomized controlled trials have been performed for second-line options. Mycophenolate mofetil is the most widely used second-line drug, and has good efficacy particularly for patients intolerant to azathioprine, but has the major disadvantage of being teratogenic. Only few and heterogeneous data on cyclosporine, tacrolimus, everolimus and sirolimus are available. More recently, experience wit...Continue Reading


Jul 1, 1988·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·A J StellonR Williams
Nov 11, 1985·The Medical Journal of Australia·S P MistilisS W McCarthy
Apr 1, 1971·The Quarterly Journal of Medicine·G C CookS Sherlock
Jun 1, 1984·The Journal of Pediatrics·G MaggioreD Alagille
Oct 12, 1995·The New England Journal of Medicine·P J JohnsonR Williams
Dec 1, 1994·Alimentary Pharmacology & Therapeutics·A Danielsson, H Prytz
Nov 1, 1993·Journal of Pediatric Gastroenterology and Nutrition·G MaggioreD Alagille
Dec 1, 1993·Journal of Clinical Gastroenterology·J L PersonA G Redeker
Oct 1, 1993·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·P J Johnson, I G McFarlane
Mar 1, 1997·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·G V GregorioG Mieli-Vergani
Jun 26, 1998·Journal of Gastroenterology and Hepatology·K NakamuraI Makino
Jan 6, 1999·Journal of Hepatology·K W BurakM G Swain
Feb 6, 1999·The American Journal of Gastroenterology·N F FernandesT L Fong
Mar 6, 1999·Journal of Hepatology·F AlvarezE Alvarez
Jul 7, 1999·The Journal of Pediatrics·D DebrayO Bernard
Nov 26, 1999·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·A J CzajaK D Lindor
Dec 15, 2000·Gut·M A HeneghanI G McFarlane
Jun 21, 2001·Zeitschrift für Gastroenterologie·S KanzlerA W Lohse
Jun 21, 2001·Digestive Diseases and Sciences·R MalekzadehM Sotoudeh
Jul 10, 2001·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·M HurtovaD Samuel
Jan 5, 2002·The American Journal of Gastroenterology·A VenkataramaniM F Sorrell
Sep 28, 2002·Journal of Pediatric Gastroenterology and Nutrition·Carolina RumboBenjamin L Shneider
Jun 28, 2003·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Wolfgang HempflingTilman Sauerbruch
Dec 16, 2003·Journal of Hepatology·Giorgina Mieli-Vergani, Diego Vergani
May 21, 2004·Canadian Journal of Gastroenterology = Journal Canadien De Gastroenterologie·Shane M DevlinKelly W Burak
Jun 18, 2004·European Journal of Gastroenterology & Hepatology·Jørgen AgnholtJens F Dahlerup
Sep 15, 2004·Journal of Clinical Gastroenterology·Bashar A AqelRolland C Dickson
Mar 10, 2005·European Journal of Gastroenterology & Hepatology·Nanne K H de BoerChris J J Mulder
Apr 9, 2005·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Nanda KerkarSukru Emre
Jul 7, 2005·Liver International : Official Journal of the International Association for the Study of the Liver·Nazira ChaturEric M Yoshida
Jul 7, 2005·Liver International : Official Journal of the International Association for the Study of the Liver·Srinivas SeelaJames L Boyer
Sep 8, 2005·Journal of Clinical Gastroenterology·Albert J Czaja, Herschel A Carpenter
Sep 16, 2005·Liver International : Official Journal of the International Association for the Study of the Liver·Johannes WiegandMichael P Manns
Jan 31, 2006·Arquivos De Gastroenterologia·Marcos MucenicEduardo Luiz R Cançado

❮ Previous
Next ❯


Nov 2, 2017·Clinical Reviews in Allergy & Immunology·Carlo MainettiCarlo Selmi
Aug 9, 2019·Journal of Veterinary Internal Medicine·Tarini UllalDavid Twedt
Jun 3, 2019·European Journal of Gastroenterology & Hepatology·Zhen-Jun YuZe-Bao He
Oct 29, 2019·European Journal of Gastroenterology & Hepatology·Simon PapeEric T T L Tjwa
Feb 16, 2018·Pediatric Annals·Saumya Pathak, Deepak Kamat
Feb 7, 2020·Hepatology Communications·Parth ShahEinar Björnsson
Jun 10, 2020·JGH Open : an Open Access Journal of Gastroenterology and Hepatology·Lydia T de Moraes FalcãoEduardo L R Cancado
Oct 28, 2019·Frontline Gastroenterology·Vincent CheungJeremy F Cobbold
Dec 31, 2019·Journal of Immunology Research·Elisabeth SucherThomas Berg
Jun 27, 2019·World Journal of Gastroenterology : WJG·Marilena DurazzoGabriella Gruden
May 22, 2020·Digestive Diseases and Sciences·Bridgette B McNally, Elizabeth J Carey
Jun 11, 2020·Journal of Pediatric Gastroenterology and Nutrition·Erasmo MieleNikhil Thapar
Apr 25, 2018·World Journal of Gastroenterology : WJG·Yi DongChristoph F Dietrich
Nov 9, 2019·United European Gastroenterology Journal·Simon PapeTom Jg Gevers
Oct 8, 2020·Animal Models and Experimental Medicine·Katerina BakelaIrene Athanassakis
Sep 15, 2020·Journal of Pediatric Gastroenterology and Nutrition·Kamil JanowskiPiotr Socha
Nov 17, 2020·Journal of Paediatrics and Child Health·Looi C Ee
Feb 25, 2021·Expert Opinion on Pharmacotherapy·Yooyun ChungMichael A Heneghan
May 12, 2018·Archives of Oral Biology·Juliana Ximenes DamascenoCristiane Sá Roriz Fonteles
Apr 6, 2019·Current Medicinal Chemistry·Shahram GolbabapourBita Geramizadeh
May 1, 2021·Pharmaceutics·Artur ŚwierczekElżbieta Wyska
Jun 25, 2021·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Diego VerganiGiorgina Mieli-Vergani
Jul 3, 2021·Medical Sciences : Open Access Journal·Sanjay KalraPawan Rawal
Aug 17, 2021·Scandinavian Journal of Gastroenterology·Hydar El JamalyMartin Weltman
Sep 4, 2021·Microvascular Research·Abel Vieira de Melo BisnetoLee Chen-Chen

❮ Previous
Next ❯

Methods Mentioned


Clinical Trials Mentioned


Related Concepts

Related Feeds

Autoimmune Hepatitis

Autoimmune hepatitis formerly called lupoid hepatitis, is a chronic, autoimmune disease of the liver that occurs when the body's immune system attacks liver cells causing the liver to be inflamed. Discover the latest research on autoimmune hepatitis here.

Autoimmune Diseases

Autoimmune diseases occur as a result of an attack by the immune system on the body’s own tissues resulting in damage and dysfunction. There are different types of autoimmune diseases, in which there is a complex and unknown interaction between genetics and the environment. Discover the latest research on autoimmune diseases here.

Related Papers

Minerva gastroenterologica e dietologica
Christina Weiler-NormannAnsgar Lohse
Hepatology : Official Journal of the American Association for the Study of Liver Diseases
M A Heneghan, Ian G McFarlane
Current Opinion in Pharmacology
Reem A Abo-Zena, Mitchell E Horwitz
© 2021 Meta ULC. All rights reserved