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Treatments and drugs
By Mayo Clinic staffThe goal in treating autoimmune hepatitis is to inhibit your body's autoimmune response and slow the progress of the disease.
Prednisone
To achieve this, doctors usually prescribe an initial high dose of the corticosteroid drug prednisone, which suppresses the immune system. As soon as signs and symptoms improve, the medication is reduced to the lowest possible dose that controls the disease. Most people need to continue taking the drug for years, and sometimes for life. Although you may experience remission a few years after starting treatment, the disease usually returns when the drug is discontinued.
Prednisone side effects
Prednisone, especially when taken long term, can cause a wide range of serious side effects, including:
- Diabetes
- Thinning bones (osteoporosis)
- High blood pressure
- Glaucoma
- Difficulty fighting infection
- Thinning of your hair and skin
- Weight gain
Azathioprine (Imuran)
Because prednisone can cause such side effects, azathioprine, another immunosuppressant medication, is sometimes used along with prednisone. This helps lower the amount of prednisone needed, reducing its side effects.
Azathioprine (Imuran) side effects
Azathioprine has risks of its own, however, including:
- Decreased resistance to infection
- Nausea
- Rarely, liver damage and inflammation of the pancreas
- Rarely, cancer development after prolonged use
When these medications don't work
If you don't respond to these drugs or you have severe side effects, your doctor may prescribe cyclosporine or another immunosuppressant that may be effective. When medications don't halt the progress of the disease, or you have or develop irreversible scarring (cirrhosis) or liver failure, the remaining option is a liver transplant — a procedure that's often very successful in people with autoimmune hepatitis.
