{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T11:21:24Z","timestamp":1792581684054,"version":"4.5.0"},"reference-count":55,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T00:00:00Z","timestamp":1718841600000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hepatic sarcoidosis is an uncommon clinical condition in which clear recommendations are lacking in its treatment. We aimed to review systematically the literature on hepatic sarcoidosis treatment to guide clinicians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using MEDLINE, PubMed, CINAHL, Cochrane Library, and Google Scholar databases, we searched original articles on clinical studies reporting the outcome of adult hepatic sarcoidosis patients following treatment with various pharmacological agents. The primary end point was focused on assessing symptomatic relief and biochemical improvement posttreatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Out of 614 retrieved references, 34 published studies were eligible, providing data for a total of 268 patients with hepatic sarcoidosis. First\u2010line therapy with corticosteroids alone was reported in 187 patients, whilst ursodeoxycholic acid (UDCA) was used in 40 patients. Symptomatic and biochemical responses were reported among 113(60.4%) and 80(42.8%) cases of corticosteroids respectively, whereas UDCA showed a complete response in 23(57.5%) patients. Second\u2010line therapy was used in steroid\u2010refractory cases, with most cases being reported for azathioprine (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200932) and methotrexate (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200928). Notably, 15(46.9%) and 11(39.2%) patients showed both clinical and biochemical responses respectively. Biological therapy including anti\u2010tumor necrosis factor (anti\u2010TNF) was used as third line therapy in twelve cases with a 72.7% symptomatic and biochemical response rate each.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The quality of evidence for the treatment of hepatic sarcoidosis was poor. Nevertheless, it appears that corticosteroid or UDCA may be utilized as first\u2010line therapy. For cases that are refractory to corticosteroids, steroid\u2010sparing immunosuppressive agents and anti\u2010TNF have shown some promising results, but further high\u2010quality studies are required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jgh3.13076","type":"journal-article","created":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T03:45:57Z","timestamp":1718855157000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The clinical management of hepatic sarcoidosis: A systematic review"],"prefix":"10.1002","volume":"8","author":[{"given":"Ram Prasad","family":"Sinnanaidu","sequence":"first","affiliation":[{"name":"Gastroenterology Unit, Medical Department Universiti Malaya Medical Centre  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikneshwaran Chandra","family":"Kumar","sequence":"additional","affiliation":[{"name":"Hepatology Department Hospital Selayang  Batu Caves Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranita Hisham","family":"Shunmugam","sequence":"additional","affiliation":[{"name":"Department of Library &amp; Information Science, Faculty of Arts &amp; Social Sciences Universiti Malaya  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5824-0590","authenticated-orcid":false,"given":"Sanjiv","family":"Mahadeva","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Medical Department Universiti Malaya Medical Centre  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,20]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iac.2012.08.005"},{"key":"e_1_2_6_3_1","first-page":"87","article-title":"Hepatic sarcoidosis","volume":"1","author":"Tadros M","year":"2013","journal-title":"J. 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