Difficult to treat and refractory autoimmune hepatitis: Recent advances in pharmacological management

Figure 2 Indication of second- and third-line immunosuppressive therapy in patients with autoimmune hepatitis. Following primary immunosuppressive therapy, response to treatment should be assessed after 2–4 weeks. After checking drug compliance, concomitant etiology should be ruled out if patients do not respond to primary therapy. Subsequently, second- and third-line immunosuppressive therapy should be chosen. 6-MP: 6-mercaptopurine; 6-TG: 6-thioguanine; MASLD: Metabolic dysfunction-associated steatotic liver disease; AIH: Autoimmune hepatitis; PBC: Primary biliary cholangitis; DILI: Drug-induced liver injury; ArLD: Alcohol-related liver disease.