Document Detail


Long-term ursodeoxycholic acid therapy for primary biliary cirrhosis: a follow-up to 12 years.
MedLine Citation:
PMID:  15691295     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It is uncertain whether ursodeoxycholic acid therapy slows down the progression of primary biliary cirrhosis, according to two meta-analyses. However, the randomized trials evaluated had only a median of 24 months of follow-up. AIM: To evaluate long-term ursodeoxycholic acid therapy in primary biliary cirrhosis. METHODS: We evaluated 209 consecutive primary biliary cirrhosis patients, 69 compliant with ursodeoxycholic acid and 140 untreated [mean follow-up 5.79 (s.d. = 4.73) and 4.87 (s.d. = 5.21) years, respectively] with onset of all complications documented. Comparison was made following adjustment for baseline differences according to Cox modelling, Mayo and Royal Free prognostic models. RESULTS: Bilirubin and alkaline phosphatase concentrations improved with ursodeoxycholic acid (at 36 months, P = 0.007 and 0.018, respectively). Unadjusted Kaplan-Meier analysis showed benefit (P = 0.028), as 44 (31%) untreated and 15 (22%) ursodeoxycholic acid patients died or had liver transplantation. However, there was no difference when adjusted by Cox modelling (P = 0.267), Mayo (P = 0.698) and Royal Free models (P = 0.559). New pruritus or fatigue or other complications were not different, either before or after adjustment for baseline characteristics. CONCLUSIONS: Long-term ursodeoxycholic acid therapy did not alter disease progression in primary biliary cirrhosis patients despite a significant improvement in serum bilirubin and alkaline phosphatase consistent with, and similar to, those seen in ursodeoxycholic acid cohorts in randomized trials.
Authors:
C W Chan; F Gunsar; M Feudjo; C Rigamonti; J Vlachogiannakos; J R Carpenter; A K Burroughs
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Publication Detail:
Type:  Journal Article; Meta-Analysis    
Journal Detail:
Title:  Alimentary pharmacology & therapeutics     Volume:  21     ISSN:  0269-2813     ISO Abbreviation:  Aliment. Pharmacol. Ther.     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-02-04     Completed Date:  2005-05-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8707234     Medline TA:  Aliment Pharmacol Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  217-26     Citation Subset:  IM    
Affiliation:
Liver Transplantation and Hepatobiliary Medicine, Royal Free Hospital, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Alkaline Phosphatase / blood
Bilirubin / blood
Cholagogues and Choleretics / therapeutic use*
Disease Progression
Female
Follow-Up Studies
Humans
Liver Cirrhosis, Biliary / drug therapy*,  surgery
Liver Transplantation
Male
Middle Aged
Statistics, Nonparametric
Treatment Outcome
Ursodeoxycholic Acid / therapeutic use*
Chemical
Reg. No./Substance:
0/Cholagogues and Choleretics; 128-13-2/Ursodeoxycholic Acid; 635-65-4/Bilirubin; EC 3.1.3.1/Alkaline Phosphatase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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