Emerging treatments

Sirolimus

Sirolimus (also known as rapamycin) inhibits the mammalian target of rapamycin, and has been studied in the treatment of autoimmune hepatitis (AIH).[50][55]​ Further research is needed before this drug can be incorporated in the current management strategy.

Rituximab

Rituximab is a monoclonal antibody against CD20 that has been studied in the treatment of AIH.[50][56] Further research is needed before this drug can be incorporated in the current management strategy.

Infliximab

Infliximab, a recombinant chimeric monoclonal antibody against tumour necrosis factor-alpha, has been used as a salvage therapy in refractory AIH.[57] AIH appears to be an infrequent adverse effect of infliximab treatment.[16][58][59]

Ursodeoxycholic acid monotherapy

A hydrophilic bile acid with immunomodulatory capabilities that alter the human leukocyte antigen class I antigen expression on cellular surfaces to suppress immunoglobulin production. Ursodeoxycholic acid has been studied as adjunctive therapy in a controlled trial of patients with type 1 AIH, and in patients with primary biliary cirrhosis with additional features of AIH.[60][61] US guidelines suggest that ursodeoxycholic acid may be helpful in patients with concurrent autoimmune sclerosing cholangitis.[62]

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