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

Ibrahim Mahmoud Ajwah, Mohammed Abdullah Albalawi, Bashayer Jazza Alenazi, Saif Mohammed Alamri, Faris Essa Qubays, Abdullah Mahmoud Ajwah, Abdullah Saeed Alghamdi, Nader Awad Alanazi, Abdul Wahab Ali Asseri, Kholoud Abdullah Algamdi, Solaiman Hosaian Alenezi, Ahmad Jamil Makai, Mohamed Omar Amer


Autoimmune hepatitis (AIH) Is a chronic liver disease with female predominance. Treatment of this condition required usually a long-term corticosteroid therapy.

Current review aimed to summarize the efficacy of budesonide as a first line treatment in AIH.

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.

Out of 106 articles, only 5 included in this review. All patients included in current review were steroid naive. Budesonide in dose of 3 mg 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.

In non-cirrhotic AIH patients, budesonide was as effective as prednisolone with fewer steroid related side effects.‎
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