The Effectiveness and Tolerability of Budesonide in Treatment of Autoimmune Hepatitis: A Systematic Review

摘要

Background: Budesonide was effective in treating and keeping short-term remission with a fewer steroid- specific side effects in contrast to prednisone. Contradicting outcomes were detailed on the efficiency of budesonide in the management of Autoimmune Hepatitis. This review aiming at evaluating the use of budesonide for the treatment of autoimmune hepatitis. Methods : An electronic search was conducted in MEDLINE and EMBASE using these keywords steroids, autoimmune, liver, effectiveness, and side effects. The search was limited to clinical setting which resulted in 24 clinical studies. Results : The total number of AIH patients included in this review were 386 of which 304 females (78.7%), the sample size ranged from 9 patients to 207 and the mean age ranged from 13 years in to 54. Concerning the efficacy of Budesonide, it ranged from 15% to 78% as the end points were different among the included studies. Regarding the tolerability and side effects like Moon faces or cushingoid features, acne, heartburn, hirsutism, alopecia, osteoporosis, diabetes mellitus and easy bruising. Side effects reported in X studies and the incidence ranged from 28% to 56%. Conclusion : Budesonide could be a promising treatment option especially in patients prone to corticosteroid side effects like elderly individuals and postmenopausal women with high risk for osteoporosis or children with risk for impaired growth.