Mucenic M. Advancements in autoimmune hepatitis management: Perspectives for future guidelines. World J Hepatol 2024; 16(2): 135-139 [PMID: 38495280 DOI: 10.4254/wjh.v16.i2.135]
Corresponding Author of This Article
Marcos Mucenic, MD, PhD, Doctor, Medical Assistant, Liver Transplantation Group, Santa Casa de Porto Alegre, Independencia 75, Porto Alegre 90035-070, RS, Brazil. mmucenic@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Feb 27, 2024; 16(2): 135-139 Published online Feb 27, 2024. doi: 10.4254/wjh.v16.i2.135
Advancements in autoimmune hepatitis management: Perspectives for future guidelines
Marcos Mucenic
Marcos Mucenic, Liver Transplantation Group, Santa Casa de Porto Alegre, Porto Alegre 90035-070, RS, Brazil
Author contributions: Mucenic M wrote and revised the manuscript.
Conflict-of-interest statement: The author declares having no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marcos Mucenic, MD, PhD, Doctor, Medical Assistant, Liver Transplantation Group, Santa Casa de Porto Alegre, Independencia 75, Porto Alegre 90035-070, RS, Brazil. mmucenic@gmail.com
Received: December 3, 2023 Peer-review started: December 3, 2023 First decision: December 15, 2023 Revised: January 4, 2024 Accepted: January 23, 2024 Article in press: January 23, 2024 Published online: February 27, 2024 Processing time: 85 Days and 19.5 Hours
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.