Prednisone's Effect on Liver Enzymes

Introduction to Prednisone Therapy

The American Association for the Study of Liver Diseases recommends prednisone as a therapeutic agent to normalize elevated transaminases in autoimmune hepatitis, where 80% of patients achieve ALT less than twice the upper limit of normal within 6 months of treatment 1, 2, 3

The European Association for the Study of the Liver suggests that prednisolone, the active metabolite of prednisone, at doses of 0.5-1 mg/kg/day leads to normalization of transaminases and IgG levels as the primary therapeutic goal 4, 5
The American Association for the Study of Liver Diseases notes that 80% of patients treated with prednisolone alone or prednisolone plus azathioprine achieve serum ALT less than twice the upper limit of normal within 6 months 1, 2

The American College of Gastroenterology recommends that in non-responding patients with autoimmune hepatitis, increasing prednisone to approximately 60 mg/day is recommended to improve biochemical parameters, including transaminases 6

The American Association for the Study of Liver Diseases indicates that if transaminases are elevated in a patient on prednisone for autoimmune hepatitis, this represents inadequate disease control or non-response, not a drug effect 4, 6