British Society of Gastroenterology (BSG) guidelines for management of autoimmune hepatitis

TLDR

Autoimmune hepatitis is a chronic inflammatory liver disease that can progress to cirrhosis, liver failure, and death if untreated, and while early controlled trials advanced treatment, recent decades have seen a paucity of trials leaving many management questions unresolved. These guidelines aim to delineate optimal adult management strategies for AIH by integrating current evidence, including the 2002 and recent updates of the American Association for the Study of Liver Diseases practice guidelines. The recommendations are derived from a systematic review of published evidence and existing practice guidelines, synthesizing data from controlled trials and expert consensus to inform clinical practice.

Abstract

Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease which, if untreated, often leads to cirrhosis, liver failure and death. Major advances were made in its management based on controlled trials performed in England and the USA in the 1970s and 1980s. Unfortunately, in recent decades there has been a dearth of controlled clinical trials and, thus, many questions regarding the optimal management of this disease remain unanswered. Many promising newer immunosuppressive therapies await formal comparison with standard therapies and also many important details in relation to the application of standard therapies remain unclear. These guidelines describe the optimal management strategies in adults based on available published evidence, including the American Association for the Study of Liver Diseases practice guidelines for the diagnosis and treatment of AIH published in 2002 and recently updated.