Abstract
Background & Aims: Budesonide has a high hepatic first-pass clearance and metabolites virtually devoid of glucocorticoid activity. Our goals were to assess budesonide in patients with treatment-dependent autoimmune hepatitis and to determine if efficacy and safety justified a controlled trial. Methods: Ten patients who were dependent on continuous treatment to prevent exacerbation of their disease were treated with budesonide, 3 mg thrice daily. Results: Laboratory indices did not improve significantly during 5 ±1 months of therapy (range, 2-12 months). Three patients entered clinical and biochemical remission; 2 of them achieved histologie remission. Seven patients either deteriorated during therapy or became drug intolerant. Withdrawal symptoms complicated conversion from prednisone to budesonide treatment, and every patient developed at least 1 side effect. Lumbar spine density decreased in 2 patients, and femur density decreased in 2 patients, including 1 with lumbar spine changes. However, mean bone densities actually increased slightly in the entire group. Conclusions: Budesonide therapy was associated with a low frequency of remission and high occurrence of treatment failure and side effects in treatment-dependent autoimmune hepatitis. Findings did not support the need for a controlled treatment trial in this select population.
Original language | English (US) |
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Pages (from-to) | 1312-1316 |
Number of pages | 5 |
Journal | Gastroenterology |
Volume | 119 |
Issue number | 5 |
DOIs | |
State | Published - Jan 1 2000 |
Externally published | Yes |
ASJC Scopus subject areas
- Hepatology
- Gastroenterology