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.
Department of Gastroenterology, Otto-von-Guericke University, Leipziger Str 44, D-39120 Magdeburg, Germany. csepregi.antal@medizin.uni-magdeburg.de
Antal
A
Csepregi
Christoph
C
Röcken
Gerhard
G
Treiber
Peter
P
Malfertheiner
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