{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T19:35:10Z","timestamp":1781033710640,"version":"3.54.1"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Acute or chronic exposure to drugs or herbal and dietary supplements (HDS) can cause drug\u2010induced autoimmune\u2010like hepatitis (DI\u2010ALH), a self\u2010limiting condition resembling autoimmune hepatitis (AIH). We investigated the prevalence of drug exposure among AIH patients at diagnosis to recognise cases of DI\u2010ALH and discern features predicting AIH development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively included 705 patients diagnosed with AIH. DI\u2010ALH was defined using published criteria. The clinical, biochemical, serological, and histological data of DI\u2010ALH and AIH were analysed to identify predictors of the evolution of each phenotype.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Most patients were female (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009496, 70%), with a median age of 57\u2009years and a median follow\u2010up of 55\u2009months. A 59% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009417) reported exposure to drugs or HDS, and 8% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200958) fulfilled the criteria for DI\u2010ALH. Statins and HDS were the most common culprits. Patients with DI\u2010ALH more frequently had acute severe or fulminant hepatitis (22% vs. 12%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013) and higher transaminase levels (ALT: 966 vs. 591,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) at diagnosis. In total, 97% of the patients received immunosuppression. DI\u2010ALH patients had a faster biochemical response than i\u2010AIH patients (4 vs. 5,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.031), while treatment withdrawal was attempted in only 29% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200917). Approximately 30% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200917) of DI\u2010ALH cases presented a flare during follow\u2010up. Neither clinical, histological, nor serological findings nor RUCAM and RECAM could predict a DI\u2010ALH flare.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DI\u2010ALH is often under\u2010recognised in clinical practice, leading to unnecessary long\u2010term immunosuppression. A causal relationship between drugs and AIH, along with an attempt to withdraw treatment and long\u2010term follow\u2010up, is essential to prevent overtreatment\u2010associated risks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.70353","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T13:39:23Z","timestamp":1756215563000},"page":"362-373","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Unveiling Drug\u2010Induced Autoimmune\u2010Like Hepatitis in Autoimmune Hepatitis Patients: A Multicenter Retrospective Study"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0278-3518","authenticated-orcid":false,"given":"Pinelopi","family":"Arvaniti","sequence":"first","affiliation":[{"name":"Liver Unit Hospital Clinic of Barcelona, Institute of Biomedical Investigations August Pi and Sunyer (IDIBAPS), CIBERehd, University of Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignasi","family":"Olivas","sequence":"additional","affiliation":[{"name":"Liver Unit Hospital Clinic of Barcelona, Institute of Biomedical Investigations August Pi and Sunyer (IDIBAPS), CIBERehd, University of Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Pascual\u2010Dapena","sequence":"additional","affiliation":[{"name":"Liver Unit Hospital Clinic of Barcelona, Institute of Biomedical Investigations August Pi and Sunyer (IDIBAPS), CIBERehd, University of Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9309-2052","authenticated-orcid":false,"given":"Mar","family":"Riveiro\u2010Barciela","sequence":"additional","affiliation":[{"name":"Liver Unit, Department of Internal Medicine University Hospital Vall de Hebron  Barcelona Spain"},{"name":"CIBERehd, ERN RARE\u2010LIVER  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Esteban","sequence":"additional","affiliation":[{"name":"Liver Unit, Department of Internal Medicine University Hospital Vall de Hebron  Barcelona Spain"},{"name":"CIBERehd, ERN RARE\u2010LIVER  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Aguilar","sequence":"additional","affiliation":[{"name":"Liver Unit, Department of Internal Medicine University Hospital Vall de Hebron  Barcelona Spain"},{"name":"CIBERehd, ERN RARE\u2010LIVER  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Indhira","family":"P\u00e9rez\u2010Medrano","sequence":"additional","affiliation":[{"name":"Complexo Hospitalario Universitario de Pontevedra, Instituto de Investigaci\u00f3n Sanitaria Galicia Sur (IISGS)  Pontevedra 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Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga, IBIMA\u2010Plataforma BIONAND, CIBERehd Virgen de la Victoria, University Hospital, University of M\u00e1laga  M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1lvaro","family":"D\u00edaz\u2010Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases Group Valdecilla Research Institute (IDIVAL), Marqu\u00e9s de Valdecilla University Hospital  Santander Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"del Barrio","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases Group Valdecilla Research Institute (IDIVAL), Marqu\u00e9s de Valdecilla University Hospital  Santander 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