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Novel and more tolerable induction regimens and alternative options for management of patients intolerant or with suboptimal response to traditional therapies including in the post\u2010transplant setting remain an important unmet need. This review aims to summarize recent data on pharmacological options and investigational drugs in development for patients with AIH. Standard therapy using prednisone with or without azathioprine remains the mainstay of therapy and is effective in most patients. Budesonide may be considered for induction in early disease and in those with mild fibrosis, but has not been approved for maintenance therapy. Mycophenolate mofetil (MMF) in combination with steroids might be an alternative first\u2010line therapy, but results from a randomized trial are awaited. MMF as a second\u2010line maintenance agent has moderate efficacy though more frequent adverse events in patients with cirrhosis may be seen. Tacrolimus may be an equally effective second\u2010line option particularly in non\u2010responders, but data remain limited. Management of recurrent AIH post\u2010liver transplantation remains controversial with insufficient data to support long\u2010term steroid use. Moving forward, expanding the scope of therapeutic options to include biologics including B\u2010cell depleting agents may be a promising step. Recent insights in understanding the pathogenesis of AIH could serve as a basis for future therapies, including the elucidation of different immunoregulatory pathways and the potential role of the intestinal microbiome.<\/jats:p>","DOI":"10.1111\/liv.14062","type":"journal-article","created":{"date-parts":[[2019,2,5]],"date-time":"2019-02-05T10:10:34Z","timestamp":1549361434000},"page":"1002-1013","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Autoimmune hepatitis: Current and future therapeutic options"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4428-1636","authenticated-orcid":false,"given":"Iliana","family":"Doycheva","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Medical University Sofia Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kymberly 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