Budesonide as a first line therapy in autoimmune hepatitis: A systematic review

BackgroundAutoimmune hepatitis (AIH) Is a chronic liver disease with female predominance.Treatment of this condition required usually a long-term corticosteroid therapy. AimsCurrent review aimed to summarize the efficacy of budesonide as a first line treatment in AIH. MethodsPub 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. ResultsOut 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. ConclusionIn 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. What new information is offered in this study?Budesonide is a promising synthetic corticosteroid for treatment of AIH with low steroid related side effects. 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.