Difficult treatment decisions in autoimmune hepatitis

Table 1 Conventional corticosteroid treatment regimens for autoimmune hepatitis[19,54,55]

Schedule	Monotherapy	Combination therapy
	Prednisone only1 (mg/d)	Prednisone1 (mg/d)	Azathioprine (mg/d)
Induction period
Week 1	60	30	50
Week 2	40	20	50
Week 3	30	15	50
Week 4	30	15	50
Maintenance period
Fixed doses until end point	20	10	50
Conditions that favor each regimen	Cytopenia (severe) Absent thiopurine methyltransferase activity Pregnancy Malignancy (active) Short trial ( ≤ 6 mo) Acute severe onset	Elderly/postmenopausal state Osteoporosis Brittle diabetes Obesity Acne Emotional instability/psychosis Hypertension Prolonged therapy (≥ 6 mo)

¹Prednisolone can be used in place of prednisone in equivalent doses.