Document Detail

Effect of ursodeoxycholic acid on liver and bile duct disease in primary sclerosing cholangitis. A 3-year pilot study with a placebo-controlled study period.
MedLine Citation:
PMID:  8201224     Owner:  NLM     Status:  MEDLINE    
Primary sclerosing cholangitis is a cholestatic disease of the liver characterized by progressive fibrotic inflammation and obliteration of the extra- and/or intrahepatic bile ducts. There is no effective therapy. We, therefore, studied the safety and efficacy of ursodeoxycholic acid in patients with primary sclerosing cholangitis with or without additional ulcerative colitis. In a 1-year ursodeoxycholic acid treatment period, which preceded the controlled study period, ursodeoxycholic acid was well tolerated in 22 of 24 patients with ulcerative colitis and in all three patients without ulcerative colitis. In two patients with ulcerative colitis the dose of 750 mg ursodeoxycholic acid/day led to diarrhea, but following reduction of the dose to 500 and 250 mg/day ursodeoxycholic acid was well tolerated. After 1 year of ursodeoxycholic acid treatment, 20 patients were randomly assigned to receive either ursodeoxycholic acid 750 mg/day or placebo. All of them finished a double-blind, placebo-controlled study period. During ursodeoxycholic acid treatment, the liver enzymes improved markedly. The difference in alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and gamma-glutamyltransferase between the placebo and ursodeoxycholic acid group was significant (p < 0.05). Following ursodeoxycholic acid treatment, pruritus and fatigue improved in half of the patients but the difference between the placebo and ursodeoxycholic acid group was not significant. According to the ethical guidelines, after 3 months of placebo treatment, the controlled study had to be discontinued because of a more than twofold increase of serum transaminases in 8/10 patients on placebo. After the end of the controlled study, all patients were continuously treated with ursodeoxycholic acid for up to 4 years.(ABSTRACT TRUNCATED AT 250 WORDS)
A Stiehl; S Walker; L Stiehl; G Rudolph; W J Hofmann; L Theilmann
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of hepatology     Volume:  20     ISSN:  0168-8278     ISO Abbreviation:  J. Hepatol.     Publication Date:  1994 Jan 
Date Detail:
Created Date:  1994-07-01     Completed Date:  1994-07-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8503886     Medline TA:  J Hepatol     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  57-64     Citation Subset:  IM    
Department of Internal Medicine, University of Heidelberg, Germany.
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MeSH Terms
Bile Acids and Salts / blood
Cholangiopancreatography, Endoscopic Retrograde
Cholangitis, Sclerosing / complications,  diagnosis,  drug therapy*
Clinical Enzyme Tests
Colitis, Ulcerative / complications
Double-Blind Method
Liver / pathology
Liver Function Tests
Pilot Projects
Time Factors
Ursodeoxycholic Acid / therapeutic use*
Reg. No./Substance:
0/Bile Acids and Salts; 128-13-2/Ursodeoxycholic Acid

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