Cortisone is the most frequently used treatment: after high initial doses, maintenance doses are usually quite low
I was diagnosed with autoimmune hepatitis in 2018 and started on prednisone (25mg). Gradually, with the stabilization of the transaminases, I halved the dose. Now, four years later, I’m on 5 mg. I would like to know if autoimmune hepatitis can be cured and above all if the prolonged use of cortisone can cause damage to health.
He answers Roberta D’AmbrosioHead of Gastroenterology Clinics, Ospedale Maggiore Policlinico, Milan (GO TO THE FORUM)
Il cortisone it represents the most frequently used therapy for the treatment of autoimmune hepatitis. As in your case, after high initial dosages, you get to maintenance doses which are normally quite low. In many cases we tend to stick to these dosages for the risk of recurrence which you may witness the suspension of treatment; the recurrence very often requires having to restart the treatment at high doses. In other cases it is opted for an attempt to discontinue therapy, generally by scheduling close post-hold checks. Someone prefers to run a liver biopsy before suspension, to evaluate the effective absence of inflammation even at a microscopic level.
The decision on the continuation or suspension of therapy must be shared between the doctor and the patient. Among the factors to consider are the nature of autoimmune hepatitis (e.g. primitive or secondary), the presence of comorbidity which could contraindicate the prolonged intake of even minimal doses of cortisone, the severity of the underlying disease (e.g. liver fibrosis) and the patient’s adherence to any close post-treatment monitoring. The side effects associated with taking cortisone are generally mild, manageable and transientespecially in consideration of the rapid decalage of dosages: the most important are related to changes in blood sugar levels (particularly in diabetic subjects) e of blood pressure values; insomnia can be counteracted by taking the drug in the morning.
December 21, 2022 (change December 21, 2022 | 16:24)
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