{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T17:01:04Z","timestamp":1774630864900,"version":"3.50.1"},"reference-count":55,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T00:00:00Z","timestamp":1733011200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Paediatric autoimmune liver disease (pAILD) is a rare condition with serious health implications. Notwithstanding treatment advancements, areas of uncertainty and knowledge gaps still exist. We here investigated the real\u2010life approach to pAILD management in Europe.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A survey was distributed to members of the European Rare Liver Disease Reference Network (ERN RARE\u2010LIVER) and the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Hepatology Interest Group. Information was gathered regarding clinical activity, medications used, and access to paediatric drug formulations at each site.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010six centres from 22 European countries responded to the survey. The majority are exclusively paediatric units (86%). Among participants, 80% follow &lt;50 children with pAILD, of which 25%\u201350% are &lt;10 years old in 44% of centres. All centres use predniso(lo)ne as first\u2010line therapy, alone (15\/36) or with azathioprine (21\/36). Azathioprine and mycophenolate are the preferred second\u2010line options in centres using first\u2010line steroid monotherapy (11\/15) or combined steroid\u2010azathioprine (19\/21), respectively. Tacrolimus is used as third\u2010line agent in 15\/36 centres. Proactive measurement of drug metabolites and target levels vary widely among centres. Paediatric predniso(lo)ne formulations are commercially available in 7\/22 European countries, azathioprine in 3, mycophenolate in 14, tacrolimus in 15 and ursodeoxycholic acid in 14. When paediatric formulations are unavailable, children are treated with magisterial preparations or \u2018solid\u2019 formulations (crushed or intact).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Treatment of pAILD in Europe varies widely in terms of medications used and treatment monitoring. Availability of paediatric drug formulations across Europe is limited. Collaborative initiatives are needed to define evidence\u2010based strategies for management of pAILD and to promote an equal, age\u2010appropriate treatment for affected children.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jpn3.12424","type":"journal-article","created":{"date-parts":[[2024,12,2]],"date-time":"2024-12-02T06:49:26Z","timestamp":1733122166000},"page":"260-270","source":"Crossref","is-referenced-by-count":5,"title":["Current practice in the management of paediatric autoimmune liver disease in Europe"],"prefix":"10.1002","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7177-2847","authenticated-orcid":false,"given":"Mara","family":"Cananzi","sequence":"first","affiliation":[{"name":"Unit of Paediatric Gastroenterology, Digestive Endoscopy, Hepatology and Care of the Child with Liver Transplantation, Department of Women's and Children's Health University Hospital of Padova Padova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne 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