{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:56:22Z","timestamp":1792684582196,"version":"4.5.0"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>In patients with non-severe acute or chronic autoimmune hepatitis (AIH) without cirrhosis, clinical practice guidelines recommend indistinct use of prednisone or budesonide. However, budesonide is infrequently used in clinical practice. We aimed to describe its use and compare its efficacy and safety with prednisone as first-line options.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Approach and Results:<\/jats:title>\n                    <jats:p>\n                      This was a retrospective, multicenter study of 105 naive AIH patients treated with budesonide as the first-line drug. The control group included 276 patients treated with prednisone. Efficacy was assessed using logistic regression and validated using inverse probability of treatment weighting propensity score. The median time to biochemical response (BR) was 3.1 months in patients treated with budesonide and 4.9 months in those with prednisone. The BR rate was significantly higher in patients treated with prednisone (87% vs. 49% of patients with budesonide,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001). The probability of achieving BR, assessed using the inverse probability of treatment weighting propensity score, was significantly lower in the budesonide group (OR = 0.20; 95% CI: 0.11\u20130.38) at any time during follow-up, and at 6 (OR = 0.51; 95% CI: 0.29\u20130.89) and 12 months after starting treatment (0.41; 95% CI: 0.23\u20130.73). In patients with transaminases &lt;2 \u00d7 upper limit of normal, BR was similar in both treatment groups. Prednisone treatment was significantly associated with a higher risk of adverse events (24.2% vs. 15.9%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.047).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In the real-life setting, the use of budesonide as first-line treatment is low, and it is generally prescribed to patients with perceived less disease activity. Budesonide was inferior to prednisone as a first-line drug but was associated with fewer side effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/hep.0000000000000018","type":"journal-article","created":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T23:00:09Z","timestamp":1673910009000},"page":"1095-1105","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":52,"title":["Budesonide as first-line treatment in patients with autoimmune hepatitis seems inferior to standard predniso(lo)ne administration"],"prefix":"10.1097","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3610-2263","authenticated-orcid":false,"given":"\u00c1lvaro","family":"D\u00edaz-Gonz\u00e1lez","sequence":"first","affiliation":[{"name":"Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases Group, Valdecilla Research Institute (IDIVAL), Marqu\u00e9s de Valdecilla University Hospital, Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3478-9981","authenticated-orcid":false,"given":"Manuel","family":"Hern\u00e1ndez-Guerra","sequence":"additional","affiliation":[{"name":"Servicio de Aparato Digestivo, Hospital Universitario de Canarias, La Laguna, Espa\u00f1a"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6104-8612","authenticated-orcid":false,"given":"Indhira","family":"P\u00e9rez-Medrano","sequence":"additional","affiliation":[{"name":"Servicio de Aparato Digestivo, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Espa\u00f1a"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4379-6486","authenticated-orcid":false,"given":"V\u00edctor","family":"Sapena","sequence":"additional","affiliation":[{"name":"Medical Statistics Core Facility, Institut D\u2019Investigacions Biom\u00e9diques August Pi i Sunyer (IDIBAPS), Hospital Clinic Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9309-2052","authenticated-orcid":false,"given":"Mar","family":"Riveiro-Barciela","sequence":"additional","affiliation":[{"name":"Liver Unit, Internal Medicine Department, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Barcelona Hospital Campus, Barcelona, Spainand CIBERehd"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4368-8939","authenticated-orcid":false,"given":"Ana","family":"Barreira-D\u00edaz","sequence":"additional","affiliation":[{"name":"Liver Unit, Internal Medicine Department, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Barcelona Hospital Campus, Barcelona, Spainand CIBERehd"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0072-459X","authenticated-orcid":false,"given":"Elena","family":"G\u00f3mez","sequence":"additional","affiliation":[{"name":"Servicio de Aparato Digestivo, Hospital Universitario 12 de Octubre, Madrid, Espa\u00f1a"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9117-5049","authenticated-orcid":false,"given":"Rosa M","family":"Morillas","sequence":"additional","affiliation":[{"name":"Hepatology Department, Hospital Germans Trias i Pujol and Germans Trias i Pujol Research Institute, IGTP, Badalona, Department of Medicine, Universitat Aut\u00f2noma de Barcelona; Centro de investigaci\u00f3n biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas, CIBERehd"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6276-7405","authenticated-orcid":false,"given":"Mar\u00eda","family":"Del Barrio","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases Group, Valdecilla Research Institute (IDIVAL), Marqu\u00e9s de Valdecilla University Hospital, Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laia","family":"Escud\u00e9","sequence":"additional","affiliation":[{"name":"Liver Unit, Hospital Cl\u00ednic de Barcelona, Health Care Provider of the European Reference Network on Rare Liver Disorders (ERN-Liver), Institut D\u2019Investigacions Biom\u00e9diques August Pi i Sunyer (IDIBAPS), Centro de investigaci\u00f3n biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas, CIBERehd, University of Barcelona, Barcelona, Espa\u00f1a"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0326-4119","authenticated-orcid":false,"given":"Beatriz","family":"Mateos","sequence":"additional","affiliation":[{"name":"Servicio de Aparato Digestivo, Hospital Universitario Ram\u00f3n y Cajal, CIBERehd, IRYCIS, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3675-1135","authenticated-orcid":false,"given":"Diana","family":"Horta","sequence":"additional","affiliation":[{"name":"Servicio de Aparato Digestivo, Hospital Universitari Mutua de Terrassa, Terrassa, Espa\u00f1a"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4923-7466","authenticated-orcid":false,"given":"Judith","family":"G\u00f3mez","sequence":"additional","affiliation":[{"name":"Servicio de Aparato Digestivo, Hospital Universitario de Burgos, Burgos, 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