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ABSTRACT
Background
Autoimmune hepatitis (AIH) Is a chronic liver disease with female predominance. Treatment of this condition required usually a long-term corticosteroid therapy.
Aims
Current review aimed to summarize the efficacy of budesonide as a first line treatment in AIH.
Methods
Pub Med, Google Scholar, and EBSCO databases were systematically search for relevant articles . The terms autoimmune hepatitis , budesonide, prednisolone and azathioprine were used. Out of hundred and six, only five fulfilled the inclusion criteria.
Results
Out of 106 articles, only 5 included in this review. All patients included in current review were steroid naive. Budesonide in dose of 3mg trice a day was the used in 2 out of 5 studies both document complete platelet response in 50-80 per cent. Azathioprine was added to budesonide in 3 out of 5 studies, 60 per cent of the budesonide treated patient had a complete platelet response versus 30-40 per cent of prednisolone treated group.
Conclusion
In non-cirrhotic AIH patients, budesonide was as effective as prednisolone with fewer steroid related side effects.
Key Words
Autoimmune hepatitis, budesonide, azathioprine
What this study adds:
1. What is known about this subject?
Prednisolone monotherapy or combined with azathioprine is a standard treatment regimen for AIH.
2. What new information is offered in this study? Budesonide is a promising synthetic corticosteroid for treatment of AIH with low steroid related side effects.
3. What are the implications for research, policy, or practice?
Budesonide as well as other agent such as cyclophosphamide, are investigatory medication. Patients with AIH should be treated with the standard medications.
Background
Autoimmune hepatitis (AIH) is a chronic liver disease characterized biochemically by elevation in serum aminotransferases (AST- ALT) and immunoglobulin G (IgG), serologically by the presence of autoantibodies such as antinuclear antibody , anti-smooth antibody , and anti -liver kidney microsomal antibody or anti -soluble liver antigen antibody and histologically by interface hepatitis.1 As a result of this chronic inflammatory process, cirrhosis and subsequently occurrence of hepatocellular carcinoma.2
Corticosteroid in the form of high dose prednisolone or a lower dose of prednisolone in combination with azathioprine is the standard treatment of AIH with remission rate reaching up to 80 per cent. Since majority of the patients will require a long-term maintenance therapy, they are at...