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

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.