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ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 4
Apr.  2023
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Article Navigation >  Journal of Clinical Hepatology  > 2023  >  39(4): 915-921

Research advances in pharmacotherapy for autoimmune hepatitis

DOI: 10.3969/j.issn.1001-5256.2023.04.026
  • 1.

    The First Clinical Medical College of Shanxi Medical University, Taiyuan 030000, China

  • 2.

    Department of Gastroenterology, The First Hospital of Shanxi Medical University, Taiyuan 030000, China

Research funding:

China Foundation for International Scientific Exchange (Z2020LSXD05)

More Information
  • Corresponding author: DANG Xiaohong, xh.Dang@163.com (ORCID: 0000-0001-6748-9638)
  • Received Date: 2022-08-01
  • Accepted Date: 2022-09-01
  • Published Date: 2023-04-20
    Abstract
  • Autoimmune hepatitis (AIH) is an immune-mediated chronic inflammatory liver disease. At present, standard treatment is effective in most AIH patients, and second- or third-line pharmacotherapy can be selected for patients who have suboptimal response to standard treatment or cannot tolerate the side-effects of the drugs. Novel therapies are undergoing clinical trials with the further exploration of the pathogenesis of AIH. This article reviews the current research advances in pharmacotherapy for AIH.

     

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    • References(45)
  • [1]
    VERGANI D, TERZIROLI BERETTA-PICCOLI B, MIELI-VERGANI G. A reasoned approach to the treatment of autoimmune hepatitis[J]. Dig Liver Dis, 2021, 53(11): 1381-1393. DOI: 10.1016/j.dld.2021.05.033.
    [2]
    KATSUMI T, UENO Y. Epidemiology and surveillance of autoimmune hepatitis in Asia[J]. Liver Int, 2022, 42(9): 2015-2022. DOI: 10.1111/liv.15155.
    [3]
    LV T, LI M, ZENG N, et al. Systematic review and meta-analysis on the incidence and prevalence of autoimmune hepatitis in Asian, European, and American population[J]. J Gastroenterol Hepatol, 2019, 34(10): 1676-1684. DOI: 10.1111/jgh.14746.
    [4]
    PAPE S, SCHRAMM C, GEVERS TJ. Clinical management of autoimmune hepatitis[J]. United European Gastroenterol J, 2019, 7(9): 1156-1163. DOI: 10.1177/2050640619872408.
    [5]
    MACK CL, ADAMS D, ASSIS DN, et al. Diagnosis and management of autoimmune hepatitis in adults and children: 2019 practice guidance and guidelines from the American Association for the Study of Liver Diseases[J]. Hepatology, 2020, 72(2): 671-722. DOI: 10.1002/hep.31065.
    [6]
    European Association for the Study of the Liver. EASL clinical practice guidelines: Autoimmune hepatitis[J]. J Hepatol, 2015, 63(4): 971-1004. DOI: 10.1016/j.jhep.2015.06.030.
    [7]
    HARTL J, EHLKEN H, SEBODE M, et al. Usefulness of biochemical remission and transient elastography in monitoring disease course in autoimmune hepatitis[J]. J Hepatol, 2018, 68(4): 754-763. DOI: 10.1016/j.jhep.2017.11.020.
    [8]
    Chinese Society of Hepatology, Chinese Medical Association. Guidelines on the dagnosis and management of autoimmune hepatitis(2021)[J]. J Clin Hepatol, 2022, 38(1): 42-49. DOI: 10.3760/cma.j.cn112138-20211112-00796

    中华医学会肝病学分会. 自身免疫性肝炎诊断和治疗指南(2021)[J]. 临床肝胆病杂志, 2022, 38(1): 42-49. DOI: 10.3760/cma.j.cn112138-20211112-00796
    [9]
    PAPE S, GEVERS T, VROLIJK JM, et al. High discontinuation rate of azathioprine in autoimmune hepatitis, independent of time of treatment initiation[J]. Liver Int, 2020, 40(9): 2164-2171. DOI: 10.1111/liv.14513.
    [10]
    PAPE S, GEVERS T, BELIAS M, et al. Predniso(lo)ne dosage and chance of remission in patients with autoimmune hepatitis[J]. Clin Gastroenterol Hepatol, 2019, 17(10): 2068-2075. e2. DOI: 10.1016/j.cgh.2018.12.035.
    [11]
    TANAKA A. Autoimmune hepatitis: 2019 update[J]. Gut Liver, 2020, 14(4): 430-438. DOI: 10.5009/gnl19261.
    [12]
    MANNS MP, WOYNAROWSKI M, KREISEL W, et al. Budesonide induces remission more effectively than prednisone in a controlled trial of patients with autoimmune hepatitis[J]. Gastroenterology, 2010, 139(4): 1198-1206. DOI: 10.1053/j.gastro.2010.06.046.
    [13]
    WOYNAROWSKI M, NEMETH A, BARUCH Y, et al. Budesonide versus prednisone with azathioprine for the treatment of autoimmune hepatitis in children and adolescents[J]. J Pediatr, 2013, 163(5): 1347-1353.e1. DOI: 10.1016/j.jpeds.2013.05.042.
    [14]
    DALEKOS GN, ARVANITI P, GATSELIS NK, et al. First results from a propensity matching trial of mycophenolate mofetil vs. azathioprine in treatment-naive AIH patients[J]. Front Immunol, 2021, 12: 798602. DOI: 10.3389/fimmu.2021.798602.
    [15]
    YU ZJ, ZHANG LL, HUANG TT, et al. Comparison of mycophenolate mofetil with standard treatment for autoimmune hepatitis: a meta-analysis[J]. Eur J Gastroenterol Hepatol, 2019, 31(7): 873-877. DOI: 10.1097/MEG.0000000000001367.
    [16]
    ROBERTS SK, LIM R, STRASSER S, et al. Efficacy and safety of mycophenolate mofetil in patients with autoimmune hepatitis and suboptimal outcomes after standard therapy[J]. Clin Gastroenterol Hepatol, 2018, 16(2): 268-277. DOI: 10.1016/j.cgh.2017.09.063.
    [17]
    SANTIAGO P, SCHWARTZ I, TAMARIZ L, et al. Systematic review with meta-analysis: mycophenolate mofetil as a second-line therapy for autoimmune hepatitis[J]. Aliment Pharmacol Ther, 2019, 49(7): 830-839. DOI: 10.1111/apt.15157.
    [18]
    DESWAL S, SRIVASTAVA A. Role of allopurinol in optimizing thiopurine therapy in patients with autoimmune hepatitis: A review[J]. J Clin Exp Hepatol, 2017, 7(1): 55-62. DOI: 10.1016/j.jceh.2017.01.115.
    [19]
    CZAJA AJ, CARPENTER HA. Thiopurine methyltransferase deficiency and azathioprine intolerance in autoimmune hepatitis[J]. Dig Dis Sci, 2006, 51(5): 968-975. DOI: 10.1007/s10620-006-9336-5.
    [20]
    de BOER YS, van GERVEN NM, de BOER NK, et al. Allopurinol safely and effectively optimises thiopurine metabolites in patients with autoimmune hepatitis[J]. Aliment Pharmacol Ther, 2013, 37(6): 640-646. DOI: 10.1111/apt.12223.
    [21]
    AL-SHAMMA S, MCCRUDDEN R, MCLAUGHLIN S. Letter: allopurinol co-therapy is safe and effective in autoimmune hepatitis[J]. Aliment Pharmacol Ther, 2013, 37(9): 919. DOI: 10.1111/apt.12285.
    [22]
    HVBENER S, OO YH, THAN NN, et al. Efficacy of 6-mercaptopurine as second-line treatment for patients with autoimmune hepatitis and azathioprine intolerance[J]. Clin Gastroenterol Hepatol, 2016, 14(3): 445-453. DOI: 10.1016/j.cgh.2015.09.037.
    [23]
    DOYCHEVA I, WATT KD, GULAMHUSEIN AF. Autoimmune hepatitis: Current and future therapeutic options[J]. Liver Int, 2019, 39(6): 1002-1013. DOI: 10.1111/liv.14062.
    [24]
    van den BRAND FF, van NIEUWKERK C, VERWER BJ, et al. Biochemical efficacy of tioguanine in autoimmune hepatitis: a retrospective review of practice in the Netherlands[J]. Aliment Pharmacol Ther, 2018, 48(7): 761-767. DOI: 10.1111/apt.14939.
    [25]
    LEGUÉ C, LEGROS L, KAMMERER-JACQUET S, et al. Safety and efficacy of 6-thioguanine as a second-line treatment for autoimmune hepatitis[J]. Clin Gastroenterol Hepatol, 2018, 16(2): 290-291. DOI: 10.1016/j.cgh.2017.07.032.
    [26]
    ROBERTS SK, STRASSER SI, NICOLL AJ, et al. Efficacy and safety profile of calcineurin inhibitor salvage therapy in autoimmune hepatitis[J]. Scand J Gastroenterol, 2020, 55(11): 1309-1317. DOI: 10.1080/00365521.2020.1821764.
    [27]
    NOGUCHI F, CHU PS, TANIKI N, et al. Long-term observation of cyclosporine as second-line therapy in adults for severe acute autoimmune hepatitis[J]. Hepatology, 2021, 73(6): 2594-2597. DOI: 10.1002/hep.31597.
    [28]
    CUARTEROLO ML, CIOCCA M, LÓPEZ S, et al. Autoimmune hepatitis in children: prednisone plus azathioprine versus cyclosporine: A randomized trial[J]. J Pediatr Gastroenterol Nutr, 2020, 71(3): 376-380. DOI: 10.1097/MPG.0000000000002776.
    [29]
    NASTASIO S, SCIVERES M, MATARAZZO L, et al. Long-term follow-up of children and young adults with autoimmune hepatitis treated with cyclosporine[J]. Dig Liver Dis, 2019, 51(5): 712-718. DOI: 10.1016/j.dld.2018.10.018.
    [30]
    ZIZZO AN, VALENTINO PL, SHAH PS, et al. Second-line agents in pediatric patients with autoimmune hepatitis: A systematic review and meta-analysis[J]. J Pediatr Gastroenterol Nutr, 2017, 65(1): 6-15. DOI: 10.1097/MPG.0000000000001530.
    [31]
    FERRE-ARACIL C, RIVEIRO-BARCIELA M, TRAPERO-MARUGÁN M, et al. Tacrolimus as an effective and durable second-line treatment for chronic autoimmune hepatitis: A multicentric study[J]. Dig Dis Sci, 2021, 66(8): 2826-2832. DOI: 10.1007/s10620-020-06569-9.
    [32]
    ABDOLLAHI M, EKRAMI NK, GHOJAZADEH M, et al. Tacrolimus and mycophenolate mofetil as second-line treatment in autoimmune hepatitis: Is the evidence of sufficient quality to develop recommendations?[J]. World J Gastroenterol, 2020, 26(38): 5896-5910. DOI: 10.3748/wjg.v26.i38.5896.
    [33]
    HARIDY J, NICOLL A, SOOD S. Methotrexate therapy for autoimmune hepatitis[J]. Clin Gastroenterol Hepatol, 2018, 16(2): 288-289. DOI: 10.1016/j.cgh.2017.07.003.
    [34]
    CHANG C, TANAKA A, BOWLUS C, et al. The use of biologics in the treatment of autoimmune liver disease[J]. Expert Opin Investig Drugs, 2020, 29(4): 385-398. DOI: 10.1080/13543784.2020.1733527.
    [35]
    WEILER-NORMANN C, SCHRAMM C, QUAAS A, et al. Infliximab as a rescue treatment in difficult-to-treat autoimmune hepatitis[J]. J Hepatol, 2013, 58(3): 529-534. DOI: 10.1016/j.jhep.2012.11.010.
    [36]
    THAN NN, HODSON J, SCHMIDT-MARTIN D, et al. Efficacy of rituximab in difficult-to-manage autoimmune hepatitis: Results from the International Autoimmune Hepatitis Group[J]. JHEP Rep, 2019, 1(6): 437-445. DOI: 10.1016/j.jhepr.2019.10.005.
    [37]
    ARVANITI P, GIANNOULIS G, GABETA S, et al. Belimumab is a promising third-line treatment option for refractory autoimmune hepatitis[J]. JHEP Rep, 2020, 2(4): 100123. DOI: 10.1016/j.jhepr.2020.100123.
    [38]
    CHATRATH H, ALLEN L, BOYER TD. Use of sirolimus in the treatment of refractory autoimmune hepatitis[J]. Am J Med, 2014, 127(11): 1128-1131. DOI: 10.1016/j.amjmed.2014.06.016.
    [39]
    YTTING H, LARSEN FS. Everolimus treatment for patients with autoimmune hepatitis and poor response to standard therapy and drug alternatives in use[J]. Scand J Gastroenterol, 2015, 50(8): 1025-1031. DOI: 10.3109/00365521.2014.998271.
    [40]
    CZAJA AJ. Exploring the pathogenic role and therapeutic implications of interleukin 2 in autoimmune hepatitis[J]. Dig Dis Sci, 2021, 66(8): 2493-2512. DOI: 10.1007/s10620-020-06562-2.
    [41]
    SAADOUN D, ROSENZWAJG M, JOLY F, et al. Regulatory T-cell responses to low-dose interleukin-2 in HCV-induced vasculitis[J]. N Engl J Med, 2011, 365(22): 2067-2077. DOI: 10.1056/NEJMoa1105143.
    [42]
    TODO S, YAMASHITA K, GOTO R, et al. A pilot study of operational tolerance with a regulatory T-cell-based cell therapy in living donor liver transplantation[J]. Hepatology, 2016, 64(2): 632-643. DOI: 10.1002/hep.28459.
    [43]
    O'BRIEN CB, BARNEA ER, MARTIN P, et al. Randomized, double-blind, placebo-controlled, single ascending dose trial of synthetic preimplantation factor in autoimmune hepatitis[J]. Hepatol Commun, 2018, 2(10): 1235-1246. DOI: 10.1002/hep4.1239.
    [44]
    XIANG M, LIU T, TAN W, et al. Effects of kinsenoside, a potential immunosuppressive drug for autoimmune hepatitis, on dendritic cells/CD8+ T cells communication in mice[J]. Hepatology, 2016, 64(6): 2135-2150. DOI: 10.1002/hep.28825.
    [45]
    S'WIERCZEK A, POMIERNY B, WYSKA E, et al. Pharmacokinetic/pharmacodynamic assessment of selective phosphodiesterase inhibitors in a mouse model of autoimmune hepatitis[J]. J Pharmacol Exp Ther, 2022, 381(2): 151-163. DOI: 10.1124/jpet.121.001004.
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