получавших лечение. При этом наблюдается значительно меньшая частота развития побочных эффекModern therapeutic modes of treatment of autoimmune hepatitis
Abstract
The aim of review. To present the standard and alternative therapeutic modes used at treatment of autoimmune hepatitis (AIH).
Original positions. Autoimmune hepatitis is a chronic inflammatory disease of the liver of the unknown etiology, accompanied by elevation of serum transaminase level, hypergammaglobulinemia and circulation of the fixed spectrum of autoantibodies in the blood. In most of the cases disease can be treated by combination of prednisolon and azathioprin. However, according to current data, 20% of the patients remain resistant to these agents or have low tolerability, 10 % have to discontinue treatment due to development of serious side effects. Budesonide is a synthetic glucocorticosteroid which is characterized by rapid metabolism in the liver, having no systemic action. Results of some studies on efficacy and safety of application of budesonide at patients with AIH at various stages of disease are published in the world literature. In the review the data on epidemiology, clinical, diagnostics and main therapeutic strategy at autoimmune hepatitis are covered.
Conclusion. Now the combination of prednisolon and azathioprin serves as the classical mode for AIH treatment. Results of original studies demonstrated, that budesonide can be a drug of the 1-st line in patients who received no previous treatment. So, considerably less frequency of side effects development, than at intake of prednisolon and azathioprin combination is observed. However application of budesonide for treatment of liver cirrhosis patients is related to quite high risk of development steroid-related side effects and lower frequency of remission induction.
About the Authors
V. T. Ivashkin
Московская медицинская академия им. И.М. Сеченова
Russian Federation
Russian Federation
M. A. Morozova
Московская медицинская академия им. И.М. Сеченова
Russian Federation
Russian Federation
M. V. Mayevskaya
Московская медицинская академия им. И.М. Сеченова
Russian Federation
Russian Federation
A. O. Buyeverov
Московская медицинская академия им. И.М. Сеченова
Russian Federation
Russian Federation
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Review
For citations:
Ivashkin V.T., Morozova M.A., Mayevskaya M.V., Buyeverov A.O. получавших лечение. При этом наблюдается значительно меньшая частота развития побочных эффекModern therapeutic modes of treatment of autoimmune hepatitis. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2009;19(4):4-12. (In Russ.)
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