title: Management of autoimmune hepatitis.
abstract: OBJECTIVE
  Autoimmune hepatitis (AIH) is a chronic, progressive hepatitis of uncertain cause which has fluctuating activity characterized by periods of flares and remissions. Initial placebo-controlled trials carried out in the 1970s demonstrated that immunosuppression with steroids was extremely effective in reducing flares and progression of disease. The late 1980s-1990s could be described as the 'Dark Ages' of AIH treatment research. Very few clinical studies were performed during this time, although it became increasingly apparent that not all patients tolerated or responded to traditional immunosuppression, and that not all patients were easy to diagnose because of overlapping features with other autoimmune conditions. Fortunately, clinical research in the treatment of AIH has experienced a renaissance in the 21st century.
  
  
  RESULTS
  This review highlights some of the more important recent discoveries, including the creation of the clinically useful short form of the autoimmune hepatitis diagnostic scoring system; accumulation of data supporting the use of mycophenolate and tacrolimus as second-line treatment; and the recent completion of the largest, double-blind, placebo-controlled trial of AIH treatment to date, comparing budesonide to prednisone.
  
  
  CONCLUSIONS
  These new findings are pertinent to the everyday clinical management of patients with AIH.
authors: University of Texas Southwestern Medical Center, Dallas, Texas 75390-911, USA. marlyn.mayo@utsouthwestern.edu
authors: Marlyn J
authors: MJ
authors: Mayo
mesh_terms: D001379:Azathioprine / Q000627:therapeutic use; D019819:Budesonide / Q000627:therapeutic use; D004342:Drug Hypersensitivity / Q000175:diagnosis; D019693:Hepatitis, Autoimmune / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D011686:Purine-Pyrimidine Metabolism, Inborn Errors; D016559:Tacrolimus / Q000627:therapeutic use
chemical_list: D007166:Immunosuppressive Agents; D019819:Budesonide; D009173:Mycophenolic Acid; D001379:Azathioprine; D016559:Tacrolimus