ReviewAlimentary pharmacology & therapeutics2026
Review article: Immunosuppression in Decompensated Autoimmune Hepatitis Cirrhosis - To Suppress or Not to Suppress?
Review in Alimentary pharmacology & therapeutics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Review article: Immunosuppression in Decompensated Autoimmune Hepatitis Cirrhosis - To Suppress or Not to Suppress?Alimentary pharmacology & therapeutics · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe management of decompensated autoimmune hepatitis (AIH) cirrhosis is one of the most challenging and controversial scenarios in hepatology. Clinicians face a high-stakes dilemma: whether to initiate immunosuppression to halt inflammatory activity or prioritize liver transplantation (LT) referral to avoid treatment futility and life-threatening infections.
aimsTo critically appraise the evidence regarding immunosuppression in decompensated AIH cirrhosis and propose a biologically grounded, risk-stratified framework for clinical decision-making.
methodsThis review synthesizes current observational data and retrospective studies, focusing on patient selection, the 'therapeutic window' for medical intervention and the physiological impact of cirrhosis-associated immune dysfunction.
resultsThe risks of infection, treatment futility and delayed transplant access must be weighed against the possibility of halting inflammatory activity and achieving clinical stabilization. A narrow therapeutic window exists for medical therapy. Clinical 'recompensation' is achievable in 19%-31% of cases, though this is less frequent than in other etiologies. Early dynamic response assessment-specifically changes in bilirubin and MELD-Na at weeks 1 and 4-helps distinguish responders from those requiring urgent LT. While LT offers excellent long-term survival, recurrence occurs in 20% of cases.
conclusionsManagement must shift from a 'one-size-fits-all' approach to an individualized, protocolized strategy. We advocate for a time-limited trial of immunosuppression in selected candidates, governed by strict 'stop rules' and immediate LT evaluation for non-responders or high-risk patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.