Treatment for Autoimmune Hepatitis
Medications to control your immune system (immunosuppressants)
Medications used to treat autoimmune hepatitis include:
- Prednisone. Doctors usually recommend an initial high dose of the corticosteroid drug prednisone for people with autoimmune hepatitis. 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 prednisone for years and some people for life. Although you may experience remission a few years after starting treatment, the disease usually returns when the drug is discontinued.
Prednisone, especially when taken long term, can cause a wide range of serious side effects, including diabetes, thinning bones (osteoporosis), broken bones (osteonecrosis), high blood pressure, glaucoma and weight gain.
- Azathioprine (Imuran). Azathioprine, another immunosuppressant medication, is sometimes used along with prednisone. Using both medications may reduce the dosage of prednisone needed, reducing its side effects. Side effects of azathioprine may include difficulty fighting infections and nausea. Rare side effects include liver damage, pancreas inflammation (pancreatitis) and cancer.
- Other immunosuppressants. If you don't respond to prednisone or azathioprine, your doctor may prescribe stronger immunosuppressants, such as cyclosporine (Sandimmune) or tacrolimus (Prograf).
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.
During a liver transplant, your diseased liver is removed and a healthy liver from a donor is placed in your body. Liver transplants most often use livers from deceased organ donors. In some cases, a living-donor liver transplant can be used. During a living-donor liver transplant, you receive only a portion of a healthy liver from a living donor.