Alternative treatment regimens in autoimmune hepatitis: how justified is their choice?
Autoimmune hepatitis is a progressive immune-mediated liver disease of unknown etiology. Its key characteristics include hyper-gammaglobulinemia, circulating autoantibodies, and periportal inflammation seen in a liver biopsy sample. It is not infrequent that the lack of unified diagnostic tests make...
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| Format: | Article |
| Language: | Russian |
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MONIKI
2018-11-01
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| Series: | Alʹmanah Kliničeskoj Mediciny |
| Subjects: | |
| Online Access: | https://www.almclinmed.ru/jour/article/view/887 |
| _version_ | 1818606419659718656 |
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| author | M. V. Matsievich A. O. Bueverov M. Yu. Petrachenkova |
| author_facet | M. V. Matsievich A. O. Bueverov M. Yu. Petrachenkova |
| author_sort | M. V. Matsievich |
| collection | DOAJ |
| description | Autoimmune hepatitis is a progressive immune-mediated liver disease of unknown etiology. Its key characteristics include hyper-gammaglobulinemia, circulating autoantibodies, and periportal inflammation seen in a liver biopsy sample. It is not infrequent that the lack of unified diagnostic tests makes the verification of the disease very challenging. Most patients respond well to standard immunosuppressive therapy; however, a significant proportion of them demonstrate side effects and disease relapses after treatment withdrawal. A wide range of side effects of systemic steroids and eventual disruptions with azathioprine (the agent of choice in the treatment algorithms for autoimmune hepatitis) supplies to the Russian market make it relevant to use alternative treatment regimens. In the real world practice, alternative treatment regimens are rarely used in such patients due to the absence of hard evidence of their efficacy. Low prevalence of autoimmune hepatitis, multiplicity of its clinical types, as well as a lack of understanding of its pathogeneticmechanisms hinder the synthesis of new agents and performing trials with already known immunosuppressants with a statistical power necessary to obtain persuasive data. One of solutions of the problem could be the accumulation of clinical data into registries for further systematization of the knowledge and formulation of new clinical guidelines. |
| first_indexed | 2024-12-16T14:10:34Z |
| format | Article |
| id | doaj.art-0dd1e52e28e54bfd8491cbe9a369cda4 |
| institution | Directory Open Access Journal |
| issn | 2072-0505 2587-9294 |
| language | Russian |
| last_indexed | 2024-12-16T14:10:34Z |
| publishDate | 2018-11-01 |
| publisher | MONIKI |
| record_format | Article |
| series | Alʹmanah Kliničeskoj Mediciny |
| spelling | doaj.art-0dd1e52e28e54bfd8491cbe9a369cda42022-12-21T22:28:47ZrusMONIKIAlʹmanah Kliničeskoj Mediciny2072-05052587-92942018-11-0146550451310.18786/2072-0505-2018-46-5-504-513565Alternative treatment regimens in autoimmune hepatitis: how justified is their choice?M. V. Matsievich0A. O. Bueverov1M. Yu. Petrachenkova2Tsentrosoyuz Clinical HospitalMoscow Regional Research and Clinical Institute (MONIKI); I.M. Sechenov First Moscow State Medical UniversityMedical Center "SM-Clinic"Autoimmune hepatitis is a progressive immune-mediated liver disease of unknown etiology. Its key characteristics include hyper-gammaglobulinemia, circulating autoantibodies, and periportal inflammation seen in a liver biopsy sample. It is not infrequent that the lack of unified diagnostic tests makes the verification of the disease very challenging. Most patients respond well to standard immunosuppressive therapy; however, a significant proportion of them demonstrate side effects and disease relapses after treatment withdrawal. A wide range of side effects of systemic steroids and eventual disruptions with azathioprine (the agent of choice in the treatment algorithms for autoimmune hepatitis) supplies to the Russian market make it relevant to use alternative treatment regimens. In the real world practice, alternative treatment regimens are rarely used in such patients due to the absence of hard evidence of their efficacy. Low prevalence of autoimmune hepatitis, multiplicity of its clinical types, as well as a lack of understanding of its pathogeneticmechanisms hinder the synthesis of new agents and performing trials with already known immunosuppressants with a statistical power necessary to obtain persuasive data. One of solutions of the problem could be the accumulation of clinical data into registries for further systematization of the knowledge and formulation of new clinical guidelines.https://www.almclinmed.ru/jour/article/view/887autoimmune hepatitisprednisoloneazathioprineside effectalternative treatment regimenmycophenolate mofetilmercaptopurineliver toxicitycyclosporine |
| spellingShingle | M. V. Matsievich A. O. Bueverov M. Yu. Petrachenkova Alternative treatment regimens in autoimmune hepatitis: how justified is their choice? Alʹmanah Kliničeskoj Mediciny autoimmune hepatitis prednisolone azathioprine side effect alternative treatment regimen mycophenolate mofetil mercaptopurine liver toxicity cyclosporine |
| title | Alternative treatment regimens in autoimmune hepatitis: how justified is their choice? |
| title_full | Alternative treatment regimens in autoimmune hepatitis: how justified is their choice? |
| title_fullStr | Alternative treatment regimens in autoimmune hepatitis: how justified is their choice? |
| title_full_unstemmed | Alternative treatment regimens in autoimmune hepatitis: how justified is their choice? |
| title_short | Alternative treatment regimens in autoimmune hepatitis: how justified is their choice? |
| title_sort | alternative treatment regimens in autoimmune hepatitis how justified is their choice |
| topic | autoimmune hepatitis prednisolone azathioprine side effect alternative treatment regimen mycophenolate mofetil mercaptopurine liver toxicity cyclosporine |
| url | https://www.almclinmed.ru/jour/article/view/887 |
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