PMID: 22563779May 9, 2012Paper

Nonstandard drugs and feasible new interventions for autoimmune hepatitis: part I

Inflammation & Allergy Drug Targets
Albert J Czaja

Abstract

Nonstandard drugs that target critical pathogenic pathways or immune regulatory mechanisms constitute the next generation of treatments for autoimmune hepatitis. Mycophenolate mofetil impairs the proliferation of lymphocytes, decreases autoantibody production, and induces apoptosis of activated immunocytes. Patients treated for azathioprine intolerance improve more frequently than patients treated for refractory liver disease (54% versus 10%), and mycophenolate mofetil is emerging as a rescue therapy for this population. Complete corticosteroid withdrawal is possible in 40% of patients treated with mycophenolate mofetil, and the frequency of side effects ranges from 3-34%. Budesonide in combination with azathioprine has normalized liver tests more frequently (47% versus 18%) and with fewer side effects (28% versus 53%) than standard therapy after 6 months. Budesonide is emerging as a frontline treatment in non-cirrhotic patients with uncomplicated disease or contraindications to conventional corticosteroids. Cyclosporine and tacrolimus are effective salvage agents for steroid-refractory disease, but side effects have been common and occasionally serious. The 6- thioguanine nucleotides and rapamycin are feasible treatments for a...Continue Reading

Citations

Aug 25, 2012·Digestive Diseases and Sciences·Albert J Czaja
Oct 24, 2012·Digestive Diseases and Sciences·Albert J Czaja
Jan 12, 2013·Digestive Diseases and Sciences·Albert J Czaja
Oct 16, 2012·Expert Review of Gastroenterology & Hepatology·Albert J Czaja
Oct 16, 2012·Expert Review of Gastroenterology & Hepatology·Albert J Czaja
Jun 26, 2014·Expert Opinion on Pharmacotherapy·Albert J Czaja
Jan 7, 2014·Alimentary Pharmacology & Therapeutics·A J Czaja
Mar 19, 2014·Alimentary Pharmacology & Therapeutics·A J Czaja
Dec 5, 2013·Alimentary Pharmacology & Therapeutics·A J Czaja
Aug 19, 2015·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·John M Vierling
Mar 10, 2015·Frontiers of Medicine·Farhad Sahebjam, John M Vierling

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