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.
