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Corticosteroids, for example, prednisone, prednisolone, and budesonide (Entocort) inhibit the initiation of immune responses, including those initial responses required for perpetuation of autoimmunity reactions.A randomized (treatment assigned by chance) controlled trial was carried out comparing a placebo with a low dose of prednisolone over a 3-year period.
A large study comparing the effect of azathioprine with an inactive drug (placebo) in 248 patients with PBC, however, showed no benefit.
Moreover, neither the size nor duration of these trials was sufficient to determine an effect on survival without liver transplantation.
Accordingly, more data are needed to confirm the benefit and safety in PBC of steroids alone or in combination with UDCA.
Another randomized trial compared UDCA and placebo with UDCA and prednisolone in patients with early stages of PBC.
Although improvement in liver function was similar for both groups, only the combination of UDCA and prednisolone resulted in markedly improved liver biopsies.
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But here again, more data are needed to confirm the benefit and safety of this combination.
Imuran prevents the production of new lymphocytes (white blood cells that take part in immune responses) by blocking cell division (reproduction) of the lymphocytes.
This study showed that prednisolone improved liver function and did not significantly increase the rate of bone thinning or demineralization.