Budesonide in previously untreated autoimmune hepatitis.
BACKGROUND
Autoimmune hepatitis (AIH) is a chronic liver disease that is effectively treated with immunosuppressive therapy. Predniso(lo)ne, often in combination with azathioprine, is the basic therapeutic option to induce remission. However, this regimen can cause numerous side effects. The aim of the present study was to evaluate budesonide as a treatment option in the induction of remission in patients with previously untreated AIH.


METHODS
Between October 1998 and August 1999, 12 patients were treated with 3 mg budesonide thrice daily for 3 months in this open one-arm multicenter phase IIa study. Primary end point was induction of remission indicated by a drop of aspartate aminotransferase and alanine aminotransferase levels below two times the upper limit of normal.


RESULTS
Seven of the 12 patients (58%) reached complete remission, three patients (25%) had a partial response. Thus, 10/12 individuals (83.3%) responded to therapy. Therapy was tolerated well in 10/12 cases (83.3%).


CONCLUSIONS
Budesonide monotherapy was effective in the induction of remission and well tolerated in treatment naïve patients with AIH. It should be further evaluated in prospective controlled trials and should be compared to predniso(lo)ne both in monotherapy and in combination with azathioprine.
Wiegand
Johannes
J
Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.
Schüler
Andreas
A
Kanzler
Stephan
S
Lohse
Ansgar
A
Beuers
Ulrich
U
Kreisel
Wolfgang
W
Spengler
Ulrich
U
Koletzko
Sibylle
S
Jansen
Peter L M
PL
Hochhaus
Günther
G
Möllmann
Helmut W
HW
Pröls
Markus
M
Manns
Michael P
MP
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D019819:Budesonide / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D005260:Female; D019693:Hepatitis, Autoimmune / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged
D019819:Budesonide; D000410:Alanine Transaminase