@article{10.37349/edd.2024.00042,
abstract = {Autoimmune hepatitis (AIH) is a chronic liver disease of unknown aetiology that can lead to end stage liver disease if left without treatment. Corticosteroids with or without azathioprine (AZA) are considered the recommended standard first-line treatment option for the induction and maintenance of remission. The aim of treatment is to achieve complete biochemical response (CBR), defined by normal transaminases and immunoglobulin G (IgG) within 6–12 months after treatment initiation. However, response rates to standard treatment vary widely as approximately 10–25% of cases develop intolerance, insufficient response, or rarely non-response to AZA. Mycophenolate mofetil (MMF) is an effective and safe alternative first-line treatment in AIH, based on its high rates of CBR among treatment-naive patients, but can also be considered as second-line drug in patients with poor response or intolerance to AZA. However, even after the administration of second line treatment there is a small proportion of patients with refractory disease that bear the highest probability of developing decompensated cirrhosis and hepatocellular carcinoma. For this difficult to treat subgroup of patients third-line treatments are warranted. Therefore, the aim of this review is to summarize the current evidence on second- and third-line therapies for AIH, as well as, to set the background for future perspectives on safer and more efficient treatment strategies.},
author = {Arvaniti, Pinelopi and Olivas, Ignasi and Rodriguez-Tajes, Sergio and Dalekos, George N. and Londoño, Maria-Carlota},
doi = {10.37349/edd.2024.00042},
journal = {Exploration of Digestive Diseases},
pages = {92--106},
title = {{Second- and third-line treatment agents in autoimmune hepatitis (AIH): Where do we stand?}},
url = {https://www.explorationpub.com/Journals/edd/Article/100542},
volume = {3},
year = {2024},
number = {2}
}