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Autoimmune Hepatitis pp 147–158Cite as

Strategies for Treatment Nonresponders: Second-Line Therapies and Novel Approaches

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Part of the book series: Clinical Gastroenterology ((CG))

Abstract

The current available evidence for second-line treatments of autoimmune hepatitis is based mostly on small retrospective case series. In patients who are not responding to therapy, it is imperative to ensure that these subjects are being compliant with their medications. In those who cannot tolerate the side effects or are true nonresponders, treatment with alternative medications should be considered. However, it is critical that both provider and patient understand the side effects of the medication, which can be quite severe. Education about these medications, their side effects, and the different treatment options available should be discussed with patients prior to initiating alternative therapy. While results of these studies are promising, with many agents inducing biochemical remission and allowing for weaning of steroids, they are difficult to interpret due to the lack of a common protocol for selection or management of these patients. Randomized control trials (RCT) are needed to compare these medications to the conventional therapy of prednisone and azathioprine.

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Author information

Authors and Affiliations

  1. Departments of Pediatrics, University of California, San Francisco, 94143-0538, CA, USA

    Elizabeth Mileti

  2. Division of Gastroenterology, Department of Medicine, University of California, 513 Parnassus Ave, Room S-357, San Francisco, 94143-0538, CA, USA

    Marion Peters

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  1. Elizabeth Mileti
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Correspondence to Marion Peters .

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Editors and Affiliations

  1. Toronto Western Hospital Liver Centre, Department of Medicine, University of Toronto, Bathhurst St. 399, Toronto, M5T 2S8, Ontario, Canada

    Gideon M. Hirschfield

  2. Toronto Western Hospital Liver Centre, University of Toronto, Bathhurst St. 399, Toronto, M5T 2S8, Ontario, Canada

    E. Jenny Heathcote

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Mileti, E., Peters, M. (2012). Strategies for Treatment Nonresponders: Second-Line Therapies and Novel Approaches. In: Hirschfield, G., Heathcote, E. (eds) Autoimmune Hepatitis. Clinical Gastroenterology. Springer, New York, NY. https://doi.org/10.1007/978-1-60761-569-9_8

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  • DOI: https://doi.org/10.1007/978-1-60761-569-9_8

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  • Print ISBN: 978-1-60761-568-2

  • Online ISBN: 978-1-60761-569-9

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