Advancements in autoimmune hepatitis management: Perspectives for future guidelines

Core Tip

Core Tip: Autoimmune hepatitis guidelines consider corticosteroids as first-line treatment, including budesonide as an option in patients without cirrhosis. Azathioprine is recommended to reduce corticosteroid doses and side effects. Nevertheless, there are concerns regarding its long-term malignancy risks. Recent publications suggest that these guidelines may be outdated. The efficacy of budesonide can be limited to patients with lower aminotransferases levels. The potential superiority of mycophenolate mofetil to azathioprine is under scrutiny. Additionally, there are controversies regarding treatment suspension, with a potential role for chloroquine for long-term maintenance treatment. Other therapeutic agents are still in the initial stages of research.