Z Gastroenterol 2004; 42 - 169
DOI: 10.1055/s-2004-827070

Budesonide in autoimmune liver disease

G Treiber 1, A Csepregi 1, P Malfertheiner 1
  • 1Klinik für Gastroenterologie, Hepatologie und Infektiologie, Otto-von-Guericke Universität, Magdeburg, Germany

Background: Prednis(ol)one (PRD) alone or in combination with azathioprine (AZA) is the treatment for autoimmune hepatitis (AIH). Budesonide (BUD) has been reported to be an alternative treatment of choice. Data, however, are very limited and highly controversial.

Patients and methods: Fifteen patients (F:M=11:4; mean age 51±14 ys.) with AIH were treated with BUD (Budenofalk) of 9mg/day and were followed up for 32 to 92 weeks. Four patients also presented features of an autoimmune cholestatic liver disease (PBC or PSC). In eight cases ursodeoxycholic acid and/or AZA was also given.

Results: Out of the eight patients who were given BUD as first-line therapy six entered complete remission (CR). Three patients who were in remission under PRD – because of side effects of the drug – were put on BUD and experienced CR. Two women who were on AZA or PRD and had an acute exacerbation of AIH experienced CR. Adverse effects of BUD were noted only in patients with liver cirrhosis (n=2).

Discussion: BUD – both as first- and second-line therapy – represents an effective treatment option for AIH and is associated with a low frequency of side effects. Our data indicate that patients with overlap syndrome of AIH should also be considered for BUD therapy.