Clinical management of autoimmune hepatitis.
Alanine Transaminase
/ metabolism
Aspartate Aminotransferases
/ metabolism
Autoantibodies
/ immunology
Azathioprine
/ therapeutic use
Disease Progression
Glucocorticoids
/ therapeutic use
Hepatitis, Autoimmune
/ diagnosis
Humans
Immunoglobulin G
/ immunology
Immunosuppressive Agents
/ therapeutic use
Induction Chemotherapy
Maintenance Chemotherapy
Mercaptopurine
/ therapeutic use
Mycophenolic Acid
/ therapeutic use
Prednisolone
/ therapeutic use
Autoimmune hepatitis
European Association for Study of the Liver
clinical management
induction therapy
prednisolone
prednisone
Journal
United European gastroenterology journal
ISSN: 2050-6406
Titre abrégé: United European Gastroenterol J
Pays: England
ID NLM: 101606807
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
27
06
2019
accepted:
31
07
2019
entrez:
9
11
2019
pubmed:
9
11
2019
medline:
9
11
2019
Statut:
ppublish
Résumé
Autoimmune hepatitis is a rare and chronic liver disease that is characterised by increased serum transaminases and immunoglobulin G, inflammatory liver histology and presence of circulating autoantibodies. An autoimmune hepatitis diagnosis justifies life-long treatment in most patients in order to prevent development of cirrhosis and end-stage liver disease. The cornerstone of treatment is steroid induction therapy followed by maintenance therapy with azathioprine, which is effective in most cases. For patients who do not respond to standard treatment, second-line treatment with other immunosuppressants can be effective. Treatment should be aimed at biochemical remission of the disease, which is defined as normalization of transaminases and immunoglobulin G. Patients should be monitored intensively during the first months of treatment in order to monitor side-effects, assess symptoms and individualise treatment. Specialist consultation should be sought in difficult-to-treat patients. Future studies and networking initiatives should result in optimization of current treatment strategies in autoimmune hepatitis.
Identifiants
pubmed: 31700628
doi: 10.1177/2050640619872408
pii: 10.1177_2050640619872408
pmc: PMC6826525
doi:
Substances chimiques
Autoantibodies
0
Glucocorticoids
0
Immunoglobulin G
0
Immunosuppressive Agents
0
Prednisolone
9PHQ9Y1OLM
Mercaptopurine
E7WED276I5
Aspartate Aminotransferases
EC 2.6.1.1
Alanine Transaminase
EC 2.6.1.2
Mycophenolic Acid
HU9DX48N0T
Azathioprine
MRK240IY2L
Types de publication
Journal Article
Review
Langues
eng
Pagination
1156-1163Informations de copyright
© Author(s) 2019.
Références
Hepatol Res. 2019 Jan;49(1):96-104
pubmed: 30248210
J Hepatol. 2016 Oct;65(4):769-775
pubmed: 27238753
J Hepatol. 2011 Sep;55(3):636-646
pubmed: 21238519
J Hepatol. 2012 Dec;57(6):1299-304
pubmed: 22871503
Gut. 2011 Dec;60(12):1611-29
pubmed: 21757447
Hepatology. 2005 Jul;42(1):53-62
pubmed: 15954109
Clin Gastroenterol Hepatol. 2016 Mar;14(3):445-53
pubmed: 26492846
Aliment Pharmacol Ther. 2012 Sep;36(5):449-58
pubmed: 22784257
N Engl J Med. 1995 Oct 12;333(15):958-63
pubmed: 7666914
Gastroenterology. 1996 Jan;110(1):271-4
pubmed: 8536867
Annu Rev Pharmacol Toxicol. 2012;52:275-301
pubmed: 21942628
Gut. 1975 Nov;16(11):876-83
pubmed: 1104411
Ann Rheum Dis. 2019 Feb;78(2):209-217
pubmed: 30472651
Gut. 1980 Jan;21(1):78-83
pubmed: 6988304
Am J Gastroenterol. 2015 Jul;110(7):993-9
pubmed: 26010310
Liver Int. 2019 Jan;39(1):215-221
pubmed: 30204306
Hepatology. 2010 Dec;52(6):2247-8
pubmed: 20815018
J Hepatol. 2014 Oct;61(4):876-82
pubmed: 24842305
J Hepatol. 2018 Apr;68(4):754-763
pubmed: 29180000
Liver. 1982 Jun;2(2):95-103
pubmed: 7176845
Gastroenterology. 2010 Oct;139(4):1198-206
pubmed: 20600032
Clin Gastroenterol Hepatol. 2017 Aug;15(8):1207-1217.e4
pubmed: 28215616
Hepatology. 2010 Jun;51(6):2193-213
pubmed: 20513004
World J Gastroenterol. 2017 Sep 7;23(33):6030-6048
pubmed: 28970719
Gastroenterology. 1972 Nov;63(5):820-33
pubmed: 4538724
Hepatology. 2014 Feb;59(2):612-21
pubmed: 23929808
J Hepatol. 2015 Oct;63(4):971-1004
pubmed: 26341719
Hepatology. 2018 Oct;68(4):1649-1652
pubmed: 29698571
J Hepatol. 2015 Mar;62(3):642-6
pubmed: 25457202
United European Gastroenterol J. 2018 Mar;6(2):247-254
pubmed: 29511554
Aliment Pharmacol Ther. 2018 Oct;48(7):761-767
pubmed: 30109891
Hepatology. 2012 Oct;56(4):1401-8
pubmed: 22488741
Aliment Pharmacol Ther. 2016 May;43(10):1035-47
pubmed: 26991238
Aliment Pharmacol Ther. 2019 Apr;49(7):830-839
pubmed: 30761563
Hepatology. 2011 Mar;53(3):926-34
pubmed: 21374663
Gastroenterology. 2003 Aug;125(2):298-303
pubmed: 12891528
Clin Gastroenterol Hepatol. 2017 Dec;15(12):1950-1956.e1
pubmed: 28603052
J Hepatol. 2010 Jul;53(1):191-8
pubmed: 20400196
J Autoimmun. 2018 Dec;95:34-46
pubmed: 30401504
Clin Gastroenterol Hepatol. 2019 Sep;17(10):2068-2075.e2
pubmed: 30625402
J Hepatol. 2013 Jan;58(1):141-7
pubmed: 22989569
Gastroenterology. 2011 Jun;140(7):1980-9
pubmed: 21396370
Nat Rev Dis Primers. 2018 Apr 12;4:18017
pubmed: 29644994
J Hepatol. 1999 Nov;31(5):929-38
pubmed: 10580593
Hepatol Commun. 2018 Sep 26;2(10):1235-1246
pubmed: 30411073
Aliment Pharmacol Ther. 2013 Nov;38(10):1255-66
pubmed: 24117596
Hepatology. 2015 Nov;62(5):1524-35
pubmed: 26178791
J Hepatol. 2011 Feb;54(2):374-85
pubmed: 21067838
Hepatology. 1981 Sep-Oct;1(5):431-5
pubmed: 7308988
Liver Transpl. 2019 Jun;25(6):946-959
pubmed: 30900368
J Hepatol. 2018 Mar;68(3):577-585
pubmed: 29113911