Treatment of Autoimmune Hepatitis

The goal of autoimmune hepatitis treatment is to achieve clinical and biochemical remission, which is associated with significantly improved outcomes. Induction treatment with corticosteroids and the subsequent addition of steroid-sparing therapy with gradual tapering of corticosteroids remains the standard of care. Several alternatives to azathioprine and second-line agents, such as mycophenolate mofetil, tacrolimus, cyclosporine, sirolimus, or rituximab, have been evaluated in those with intolerance or inadequate response to standard-of-care therapy. Treatment withdrawal is achievable in less than 20% of patients after 2 years of sustained remission. Liver transplantation should be considered in those with progressive liver disease or those with complications such as hepatocellular carcinoma.

Automated summary

The goal of autoimmune hepatitis treatment is achieving clinical and biochemical remission. Standard care involves induction treatment with corticosteroids and gradual tapering of steroids. Alternatives to standard therapy can be considered for patients with intolerance or inadequate response. Treatment withdrawal is achievable in less than 20% of patients after 2 years of sustained remission, and liver transplantation should be considered for patients with progressive disease or complications.