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The following is a summary of “Various Regimens for Autoimmune Hepatitis in Northern European Children Show Equivalent Outcomes at 1 Year: A Retrospective Study,” published in the May 2025 issue of Journal of Pediatrics by Jørgensen et al. 

Researchers conducted a retrospective study to compare 1-year remission rates between tacrolimus-based and prednisolone-based regimens in children with autoimmune liver disease (AILD).  

They collected data from 157 children with biopsy-confirmed AILD across 5 northern European tertiary centers, including Oslo, Stockholm, Copenhagen, Aarhus, and Vilnius. Data were gathered at baseline and at 3, 6, and 12 months. Approvals for data collection and sharing were granted in accordance with national ethical regulations (Denmark no: 3-3013-2641/1, Norway no: 20/19759, Sweden no: 2017/1394-31, Lithuania no: 2022/4˗1400˗893). Informed consent was obtained from all children and parents in Norway, while other countries waived this requirement.  

The results showed that 111 children initially received prednisolone (with or without azathioprine), and 46 received tacrolimus (with or without prednisolone), with median starting doses of prednisolone at 0.99 mg/kg and 0.43 mg/kg, respectively. Alanine transaminase (ALT) levels were comparable at baseline; however, advanced liver fibrosis was more frequent in the tacrolimus (with or without prednisolone) group. The ALT normalization rates were lower in the tacrolimus group at 3 months (26.8% vs 58.0%, P<0.001) and 6 months (46.2% vs 68.8%, P=0.014), but no significant difference was observed at 12 months (68.2% vs 76.2%, P>0.05). A similar trend was noted for immunoglobulin G levels.  

Investigators concluded that despite slower treatment response for patients initially started on tacrolimus (with or without prednisolone) at 3 and 6 months, biochemical and immunological responses to the 2 different regimens had appeared equivalent at 1 year after treatment initiation. 

Source: jpeds.com/article/S0022-3476(25)00175-1/fulltext