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Órgano Oficial de la Asociación Mexicana de Hepatología

2007, Number 4

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Ann Hepatol 2007; 6 (4)

The medical treatment for autoimmune hepatitis through corticosteroid to new immunosuppressive agents: A concise review

Soloway RD, Hewlett AT

Language: English
References: 23
Page: 204-207
PDF size: 96.03 Kb.


Text Extraction

The treatment of autoimmune hepatitis is evolving as the natural history of the disease and newer agents become available. This concise review will outline the various treatment options in these patients. Treatment with current corticosteroids and azathioprine works in most patients but issues of intolerance and incomplete response arise. These situations led to the investigation of newer immunosupressants including mycophenolate mofetil, budesonide cyclosporine, tacrolimus and ursodeoxycholic acid. The newer agents have been studied in small patient numbers so they are not first-line treatment yet but do have a clear role in those patients with intolerance of incomplete response to standard corticosteroids and azathioprine.


REFERENCES

  1. International Autoimmune Hepatitis Group report: review of criteria for diagnosis of autoimmune hepatitis. J Hepatol 1999; 31: 929-939.

  2. Cook GC, Mulligan R, Sherlock S. Controlled prospective trial of corticosteroid therapy in chronic active hepatitis. Quart J Med 1971; 158: 159-185.

  3. Soloway RD, Summerskill WH, Baggenstoss AH, Geall MG, Gitnick GL, Elveback IR, Schoenfield LJ. Clinical, biochemical, and histologic remission of severe chronic active liver disease: a controlled study of treatments and early prognosis. Gastroenterology 1972; 63: 820-833.

  4. Cooksley WG, Brabear RA, Robinson W, Harrison M, Halliday JW, Powell LW, Ng HS, et al. The prognosis of chronic active hepatitis without cirrhosis in relation to bridging necrosis. Hepatology 1986; 6: 345-8.

  5. Czaja, AJ, Freese DK. AASLD Practice Guidelines: Diagnosis and Treatment of Autoimmune Hepatitis. Hepatology 2002; 36: 479-97.

  6. Heneghan MA, Allen ML, Bornstein, Muir AJ, Tendler DA. Utility of thiopurine methyltransferase genotyping and phenotyping, and measurement of azathioprine metabolites in the management of patients with autoimmune hepatitis. J Hepatology 2006; 45: 584-591.

  7. McFarlane IG, Norris S, Langley PG, Underhill J Tredger JM. Thiopurine methyltransferase phenotype and genotype in relation to azathioprine therapy in autoimmune hepatitis. J Hepatol 2002; 37: 441-447.

  8. Ichai P, Duclos-Vallee J, Guettier C, Hamida SB, Antonini T, Delvart V, Saliba F, et al. Usefulness of corticosteroids for the treatment of severe and fulminant forms of autoimmune hepatitis. Liver Transplantation 2007; 13: 996-1003.

  9. Czaja AJ, Rakela J, Ludwig J. Features reflective of early prognosis in corticosteroid-treated severe autoimmune chronic active hepatitis. Gastroenterology 1988; 95: 448-453.

  10. Davis GL, Czaja AJ. Immediate and long-term results of corticosteroid therapy for severe idiopathic chronic active hepatitis. In: Czaja AJ, Dickson ER, eds. Chronic Active Hepatitis. The Mayo Clinic Experience. New York; Marcel Dekker, Inc., 1986: 269-283.

  11. Williams R, McFarlane IG, Johnson PJ. Azathioprine for long-term maintenance of remission in autoimmune hepatitis. New England Journal of Medicine 1995; 333: 958-963.

  12. Boyer JL, Sheela H, Sheela S, Autoimmune hepatitis type 1: Safety and efficacy of prolonged medical therapy. Liver International 2005; 25: 734-739.

  13. Csepregi A, Rochen C, Treiber G, Malfertheiner P. Budesonide induces complete remission in autoimmune hepatitis. World J Gastroenterology 2006; 12(9): 1362-1366.

  14. Manns M, Schular WJ, Lohse KS, Beuers U, Kreisel W, Spengler U, Koletzo S, et al. Budesonide in previously untreated autoimmune hepatitis. Liver international 2005; 25: 927-934.

  15. Czaja Aj Lindor KD. Failure of budesonide in a pilot study of treatment-dependent autoimmune hepatitis. Gastroenterology 2000; 119: 1312-1316.

  16. Ryder SD, Richardson PD, James PD. Mycophenolate mofetil for maintenance in autoimmune hepatitis in patients resistant to or intolerant of azathioprine. J of Hepatology 2000; 33: 371-375.

  17. Inductivo-Yu I, Adams A, Gish RG, Wakil A, Bzowej NH, Frederick RT, Bonacini M. Mycophenolate mofetil in autoimmune hepatitis not responsive or intolerant to standard immunosuppressive therapy. Clin Gastroenterol Hepatol 2007; 5(7): 799-802.

  18. Czaja AJ, Carpenter HA. Empiric therapy of autoimmune hepatitis with mycophenolate mofetil. J Clin Gastroenterol 2005; 39(9): 819-825.

  19. Van Thiel DH, Wright H, Carroll P, bu-Elmagd K, Rodriguez-Rilo H, McMichael J, Irish W, et al. Tacrolimus: a potential new treatment for autoimmune chronic active hepatitis: results of an open label preliminary trial. Am J Gastroenterol 1995; 90: 771-776.

  20. Nakamura K, Yoneda M, Yokohama S, Tamori K, Sato Y, Aso K, Aoshima M, et al. Effacacy of ursodeoxycholic acid in Japanese patients with type 1 autoimmune hepatitis. J Gastroenterolo Hepatol 1998; 13: 490-495.

  21. Czaja AJ, Carrpenter HA, Lindor KD. Ursodeoxycholic acid as an adjunctive therapy for problematic type 1 autoimmune hepatitis: a randomized placebo-controlled treatment trail. Hepatology 1999; 30: 1381-1386.

  22. Chazouilleres O, Wendum D, Serfaty L, Rosmorduc O, Poupon R. Long term outcome and response to therapy of primary biliary cirrhosis-autoimmune hepatitis overlap syndrome. Journal of Hepatology 2006; 44: 400-406.

  23. Floeani A, Rizzotto ER, Ferrara F, Carderi I, Caroli D, Blasone L, Baldo V. Clinical course and outcome of autoimmune hepatitis/primary sclerosing cholangitis overlap syndrome. Am J Gastroenterol 2005; 100: 1516-1522.




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