Insurance coverage for azathioprine to treat of autoimmune hepatitis

Abstract

Azathioprine, a drug used in the treatment of autoimmune hepatitis (AIH), is now covered by health insurance in Japan. It has long been used in combination with steroids as a standard therapy for AIH in other countries, and its use is expected to increase in Japan. Side effects of azathioprine include cholestatic hepatitis, pancreatitis, and opportunistic infections. Periodic observation is important to ensure timely treatment of adverse effects. Recently, the NUDT15 gene polymor-phism, associated with severe leukopenia, has been reported as an adverse effect of azathioprine. Although it is covered by insurance, azathioprine is still not used frequently to treat AIH in Japan, and it is necessary to clarify the indications for and problems associated with azathioprine treatment in Japan.