Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
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 Recent publications suggest that these guidelines may be outdated.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.