Other immunosuppressive agents including azathioprine, cyclosporine, mycophenolate mofetil, or methotrexate and drugs with antifibrotic properties including penicillamine, colchicine, and silymarin have not been shown to markedly improve the natural course of the disease or were associated with significant toxicity during long-term treatment [1, [288] [289] [290] [291] [292] [293] [294] [295] [296] .