Evaluation of biological therapies in autoimmune hepatitis:A casebased systematic review  

Evaluation of biological therapies in autoimmune hepatitis:A case-based systematic

作　　者：Haifa Eldew Jonathan Soldera 

机构地区：[1]Consultant in Acute Internal Medicine with Specialist Interest in Hepatology,Princess Royal University Hospital,Kings College Hospital Foundation Trust,Orpington Kent BR68ND,United Kingdom [2]Acute Medicine and Gastroenterology,University of South Wales,Cardiff CF371DL,United Kingdom

出　　处：《World Journal of Gastrointestinal Pathophysiology》2025年第1期1-13,共13页世界胃肠病理生理学杂志(英文)

摘　　要：BACKGROUND Autoimmune hepatitis(AIH)is typically treated with immunomodulators and steroids.However,some patients are refractory to these treatments,necessitating alternative approaches.Biological therapies have recently been explored for these difficult cases.AIM To assess the efficacy and safety of biologics in AIH,focusing on patients unresponsive to standard treatments and evaluating outcomes such as serological markers and histological remission.METHODS A case-based systematic review was performed following the PRISMA protocol to evaluate the efficacy and safety of biological therapies in AIH.The primary focus was on serological improvement and histological remission.The secondary focus was on assessing therapy safety and additional outcomes.A standardized search command was applied to MEDLINE,EMBASE,and Cochrane Library databases to identify relevant studies.Inclusion criteria encompassed adult AIH patients treated with biologics.Data were analyzed based on demographics,prior treatments,and therapy-related outcomes.A narrative synthesis was employed to address biases and provide a comprehensive overview of the evidence.RESULTS A total of 352 studies were reviewed,with 30 selected for detailed analysis.Key findings revealed that Belimumab led to a favourable response in five out of eight AIH patients across two studies.Rituximab demonstrated high efficacy,with 41 out of 45 patients showing significant improvement across six studies.Basiliximab was assessed in a single study,where the sole patient treated experienced a beneficial outcome.Additionally,a notable number of AIH cases were induced by anti-tumor necrosis factor(TNF)medications,including 16 cases associated with infliximab and four cases with adalimumab.All these cases showed improvement upon withdrawal of the biologic agent.CONCLUSION Belimumab and Rituximab show promise as effective alternatives for managing refractory AIH,demonstrating significant improvements in clinical outcomes and liver function.However,the variability in patient responses to

关 键 词：Autoimmune hepatitis Biological therapies BELIMUMAB RITUXIMAB BASILIXIMAB INFLIXIMAB ADALIMUMAB 

分 类 号：R57[医药卫生—消化系统]