Budesonide induces complete remission in autoimmune hepatitis.
OBJECTIVE
Prednisone and azathioprine represent the standard treatment for autoimmune hepatitis (AIH). However, only 65% of the patients enter complete histological remission. Recently, budesonide (BUD) was reported to be a promising alternative. In this study we assessed the efficacy and safety of BUD in AIH.


METHODS
Eighteen patients (12 women, 6 men; mean age 45.4+/-21 years)with AIH were treated with BUD (Budenofalk) 3 mg thrice daily and followed up for at least 24 wk. Seven patients also had features of primary biliary cirrhosis (n=5) or primary sclerosing cholangitis (n=2). Advanced liver fibrosis or cirrhosis was present in 6 patients.


RESULTS
Fifteen (83%) patients had a complete clinical and biochemical remission. Ten patients, including five with acute hepatitis,were given BUD as first-line therapy, of which seven enter remission. Three patients, two with liver cirrhosis, did not improve.All patients with second-line therapy experienced long-term remission. A histological remission was also seen in three patients. Clinically relevant BUD-induced side effects were recorded only in patients with liver cirrhosis (n=4).


CONCLUSIONS
BUD is effective in remission induction in the majority of our patients with AIH. Side effects and treatment failure was mainly observed in patients with liver cirrhosis.
Csepregi
Antal
A
Department of Gastroenterology, Otto-von-Guericke University, Leipziger Str 44, D-39120 Magdeburg, Germany. csepregi.antal@medizin.uni-magdeburg.de
Röcken
Christoph
C
Treiber
Gerhard
G
Malfertheiner
Peter
P
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D019819:Budesonide / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D019693:Hepatitis, Autoimmune / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D016879:Salvage Therapy
D000893:Anti-Inflammatory Agents; D019819:Budesonide